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Medical Insurance Worksheets


Worksheet #1
Insurance plans vary. Before choosing a plan, decide what is most important to you. This checklist can help. Put a check in front of those services that are important to you. Then see how many of these services are in Policy #1, Policy #2, and Policy #3. On the checklist, write in the coinsurance or co-payment rate, if there is one, and any limits on service.
Remember that the most important service to be covered is hospitalization. If you are not covered for hospital care, then one sickness could cost you thousands of dollars, even hundreds of thousands of dollars.

-Convenient location of
doctors and hospitals
Service Policy #1 Policy #2 Policy #3
-Hospital care      
-Surgery (inpatient
and outpatient)
     
-Office visits to
your doctor
     
-Maternity care      
-Well-baby care      
-Immunizations      
-Mammograms      
-Medical tests,
x-rays
     
-Mental health care      
-Dental care,
braces and cleaning
     
-Vision care,
eyeglasses and exams
     
-Prescription drugs      
-Home health care      
-Nursing home care      
-Services you need
that are excluded
     
Other issues that are
important to you:
-Choice of doctors      
     
-Ease of getting
an appointment
     
-Minimal paperwork      
-Waiting period before
coverage begins
     


Worksheet #2
It is difficult to determine exactly what you will spend a year on health care. You do not know whether you will be sick 6 months from now and need an operation. Hopefully, you will not.

Using this worksheet, you can begin to make some rough estimates. Much will depend on what service you need or want, how many people are in your family, your age, and other factors. Do you need to have your eyes tested this year? Will you have a mammogram or other cancer-screening test? Does your child need immunizations?

Look at your medical and insurance records from last year as a guide to what services you might use this year. Add up the actual costs to you, including premiums. Estimate what you might spend on your health care in terms of deductibles, coinsurance and/or co-payments, and services that are not covered.

Compare Policy #1, Policy #2, and Policy #3 to determine which is the best buy for you.

What is your monthly premium? Policy #1 Policy #2 Policy #3
Individual:
Family:
Multiply by 12 for annual cost:
     
What is your deductible?
(if there is one)
Individual:
Family:
   
What is your coinsurance rate
or co-payment, if there is one?
(Note if there is a higher rate
for special services, such as
outpatient mental health care.)
   
Are there any annual limits for
days or services covered and
the amount spent on you?

   
What is the maximum you will have
to pay out-of-pocket each year?

   
What is the lifetime limit,
if any, that you will be
reimbursed?

   
Total estimated yearly cost
to you:
   

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