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    Health Plan Checklist

    The following checklist can help you evaluate your current health plan, as well as others you're considering. Compare the services offered against the cost of each plan. Then choose the plan that best meets your family's needs.

    Financial Considerations

    What is the monthly premium? ________

    What is the deductible per year?________

    How much is the co-payment for each time of service?________

    What is the co-insurance percentage?________

    What is my expected cost for a typical year? __________

    Choosing a Provider

    Given the plan's participating providers, who would you chose for:

    A primary care physician___________________________________


    An urgent care center___________________________________

    A hospital___________________________________

    Evaluating Your Coverage

    Which of the following coverage is offered and how would you evaluate it: good, fair, or poor:

    ________ Treatment of chronic conditions

    ________ Treatment of pre-existing conditions

    ________ Surgical care

    ________ Emergency room visits

    ________ Inpatient hospital services

    ________ Consultations with specialists

    ________ Family planning services

    ________ Maternity services, including prenatal care and delivery

    ________ Newborn care

    ________ X-ray and laboratory services

    ________ Rehabilitation and habilitation services, including physical, speech and occupational therapy

    ________ Well-child care

    ________ Annual physical exams

    ________ Immunizations or allergy injections

    ________ Home health care or services of a licensed private duty nurse

    ________ Hospice care for the terminally ill

    ________ Care delivered at a skilled nursing facility instead of a hospital

    ________ Psychiatric care

    ________ Drug and alcohol treatment

    ________ Prescription drugs

    ________ Rental or purchase of medical equipment (such as crutches or a wheelchair)