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Medical

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How Do I Estimate My Healthcare Expenses?

The Health Plan Cost Estimator includes a specific list of the most commonly used medical services, and asks you to enter numbers for each category based on how often you and your covered dependents will use each of those services during the calendar year. The list includes:

  • Routine physicals and annual GYN exams (preventive care)
  • Well baby office visits
  • Diagnosis/treatment office visits (with your family practice doctor or internist)
  • Specialist office visits
  • Lab tests
  • Electrocardiograms
  • CAT scans
  • X-rays (chest)
  • Emergency room visits
  • Maternity care - either normal or Cesarean delivery
  • Prescription drugs - divided up by retail versus mail order, and by generic, preferred brand name and non-preferred brand name.

The tool also asks you to enter a dollar amount that represents what the total cost of medical services that aren't included in the list above are likely to be. This includes what you and the medical plan might spend on those services. So, for example, if you know you will have outpatient surgery at a cost of $1,500, you would enter that amount for additional services, and the estimator would apply any deductibles and coinsurance.

To help you estimate your likely expenses for the coming plan year (January through December), collect your statements of medical claims paid for the last year.