Choosing the Best Health Plan


AS EMPLOYERS CONTINUE TO shift more of the financial burden to their employees, the cost of health care is projected to rise by 9% for the average worker from 2008 to 2009, according to benefits-consultant Hewitt Associates. If you're considering switching your health-insurance plan during open enrollment (which usually takes place in the fall), are starting a new job or are looking for insurance on your own, you'll want to compare how each plan stacks up. In addition to reviewing what will or won't be covered, you should have a sense of how much each option will cost you in out-of-pocket expenses.

The good news is that you're likely to have some choice over your plan. Approximately 30% of employers offer three medical plan options to their employees and another 28% of employers offer two options, according to 2007-2008 data from Hewitt Associates. Options include an HMO, a PPO (a preferred provider organization), a POS (point of service), an old-fashioned indemnity plan, and a traditional EPO (exclusive provider) plan. Our calculator can help you figure out which plan gives you the most bang for the buck. By entering the amount you paid in health-care costs last year and comparing it with the costs and reimbursement policies of the plans you're considering, you can see which plan makes the most sense — at least from your wallet's perspective.

But before you crunch the numbers, here are some tips on how to use this worksheet most effectively. First, if you're considering a PPO or POS plan — which provide a different reimbursement policy for doctors you see in-network vs. out — you should probably input the appropriate information for both situations in our calculator. (You can do so side-by-side, since our worksheet can handle two plans at once.) Typically, the way these policies work is that if you go to a doctor in-network, you'll pay a small dollar amount (known as a co-pay) somewhere in the vicinity of $20 per office visit. Should you go out-of-network, you'll be subject to coinsurance, which is usually 20% of the total bill after you've met the deductible.

You may also want to dig into your summary of benefits when estimating your health-care costs. This calculator assumes that the medical expenses you enter are reimbursable — and, unfortunately, that's not always the case. Physical therapy or mental-health sessions, for example, may be restricted to a certain number of visits annually. So make sure you read all the fine print before you make your final decision. Your actual out-of-pocket expenses could also be significantly greater than our calculator's estimation if the health plan rejects a claim or asks you to cover any amount above what the plan deems reasonable or customary.

And keep in mind that price isn't everything. When comparing an HMO with a PPO, the strict managed-care plan will always be more wallet-friendly. But often times you get what you pay for. So you may opt to spend a little more out of pocket for the freedom to see the doctor of your choice.

What Will That Health Plan Really Cost You?

Calculator - Compare Health Care Plan Costs - SmartMoney.com
Bulletin
Investor Alert

New York Markets After Hours

Obamacare to blame for Cubs’ ‘tarp fiasco’?
Obamacare to blame for Cubs’ ‘tarp fiasco’?  Getty Images
Obamacare may get the credit, or blame, for an epic baseball decision.

Make $100,000 flipping homes in these cities
Make $100,000 flipping homes in these cities  Wikipedia
Investors looking to flip a home for a tidy profit now need to be a lot savvier than they used to be.

10 things firefighters and paramedics won’t tell you
10 things firefighters and paramedics won’t tell you  Getty Images
Of the vast majority of fire and medical 911 calls in the country, about 80%, are for medical emergencies.

10 good things you don’t know about Ferguson
10 good things you don’t know about Ferguson  Ferguson Brewing Co.
You know all the bad things about Ferguson, Mo. Here are 10 positive things you don’ t know, writes David Weidner.
Ferguson and money: Where did banks go?

10 biggest Emmy Award snubs of all time
The 10 biggest Emmy Award snubs of all time
These standout television performances never got their due.
Hollywood is working hard to make you cry

How Wall Street gets you to believe in market magic
Brett Arends: Do you believe in market magic? Getty Images
Commentary: Financial hocus-pocus obscures dismal reality for investors, writes Brett Arends.
Yale vs. Penn: Where are stocks headed?
Investor bullishness hits 2014 high
How to find the biggest stock-market bargains
5 companies that benefit from ALS awareness

Lack of mobility is behind labor woes: Jackson Hole
Janet Yellen  Reuters
Workers are not moving around the country to find work and that is making the labor market less resilient, an expert told central bankers at the Fed's Jackson Hole summit.
By the numbers: Yellen’s review of jobs market
Yellen: Debate over when to hike is center stage
How word cloud sums up the speech

Super-commuting: Good for career, bad for life?
Super-commuting: Good for yuor career, bad for your life? Bloomberg
Thanks to the uneven jobs recovery, more people are working very far from home. It can mean a heavy burden for families.
5 ways to stay sane as a super-commuter

Work at these 10 firms if you want to be happy
Work at these 10 companies if you want to be happy
Employees at companies with self-proclaimed great cultures get a lot of perks, but do these things make them happier workers?

NEED TO KNOW
S&P 500 pulls back from record high
Goldman nears $1 billion payment to FHFA
Ukraine: Russian convoy crossing ‘aggressive’
Valeant has votes it needs for Allergan meeting
GameStop, Foot Locker soar; Aeropostale sinks
Dynegy in $6.25B deal with Duke, Energy Capital
Avolon pursues IPO as sale talks continue
Junk bond funds see biggest inflow of 2014
Labor Day forecast: Most travelers since 2008
We love food trucks, and they love cities


Here’s why bonds are still a great investment
Trading Deck: Many think that a bond bubble is about to burst, but a continued drop in yields may have something to say about that, write Mary Anne and Pamela Aden.

iPhone 6 delays? Don’t worry about it
Despite reports about potential iPhone 6 delivery delays, analysts say it should still arrive on time.
Apple gets hedge-fund love
Apple’s next big move will shock you

New grads prefer tech over Wall Street
Banking jobs used to be at the top of list for most sought after jobs for college graduates but no longer, say industry experts.

Durable-goods orders may jump 30% in July
Tuesday's durable-goods orders figures could contain some eye-raising headlines.

Copper’s warning, gold’s scolding
Trading Deck: It's worth considering the message of copper relative to gold as an indicator of where we are in the cycle, writes Michael A. Gayed.

Disney may use drones in theme park
Though they may sound like they could exist only in Tomorrowland, Disney is working on ways to use drones in its entertainment productions.

Obama’s new plan for birth-control coverage
The Obama administration hopes to ease concerns among religious groups that have been opposed to birth-control mandates.
UnitedHealth to expand Obamacare reach

3 high-yield buys in the gaming market
The casino market has suffered in recent years, but some gaming operators may offer competitive high-yield returns.

Keurig enlists McDonald’s in coffee war
Keurig Green Mountain forges a strategic alliance with Kraft Foods that brings McDonald's a big step closer to the home-brew coffee market.
Here’s what may keep SeaWorld afloat

Leaders with big shoes to fill
Craig Menear has big shoes to fill as Home Depot's new CEO.

Ice-bucket challenge is a one-hit wonder
The success of the ice-bucket challenge, in which people dump buckets of ice on their heads to raise awareness of ALS, could be impossible to replicate.

Beer you can sing to
The beer you can listen to
Together with Telegraph Brewing Company, the band Buellton created a beer for its album “Silent Partner.”
The new summer cocktail? Rum-flavored beer

3 reasons an Obama order on immigration would backfire
Commentary: Only a congressional bill would work for the benefit of everyone, writes Diana Furchtgott-Roth.

Investors flock to Vanguard
Vanguard nears $3 trillion in assets
Investors are stepping  away from funds run by star managers.
Passive investing is now mainstream
Facts about mutual funds that may surprise

Don’t create a budget, and other finance tips
Jonathan Clements explains why it's a mistake to pay financial-adviser commissions.
Not saving for old age? At least think about it
Stop paying your kids’ student loans

Why naming a trust as a beneficiary can be tricky
RetireMentors: When people don’t want heirs to have free rein over funds, they often employ trusts. Dan Moisand explains.
Protect your retirement from the next big crash
Buy a second home now for your retirement
/conga/frontpage.html 317725
5 reasons Americans are unhappy
Why people living in one of the wealthiest countries in the world are glum
Most, least expensive states to live in
10 states with best bang for tax dollars
Americans only take half of their paid vacation

Retire Here, Not There: Michigan
Good deals on real estate are prompting boomers to retire to the Wolverine State, now making a name as the "Riviera of the Midwest".
Long-term care insurance is great for birthdays
No need to worry about Social Security

5 things to watch in Europe next week
5 things to watch in Europe next week
Deflation fears could roil financial markets and spark renewed calls for further monetary easing.
Why the EU hates your vacuum cleaner

China celebrity drug busts may be just business
China's recent arrest of some high-profile movie stars might actually about cutthroat competition among the studios.
China offers workers' comp for just shopping
/conga/today.html 317708

Markets »

64.33MDow Volume:
Avg Vol: 80.51M
Unchanged
259
Decliners
3448
Advancers
2726
Price Chg %Chg 1 Day
Range: 1 Day
  • 1 Day
  • 5 Days
  • 1 Month
  • 3 Months
  • 6 Months
  • 1 Year
  • 2 Years
Dow
/quotes/zigman/627449/realtime 17,001 -38 0.22%
Nasdaq
/quotes/zigman/12633936/realtime 4,539 +6 0.14%
S&P 500
/quotes/zigman/3870025/realtime 1,988 -4 0.20%
GlobalDow
/quotes/zigman/629063/realtime 2,606 -9 0.35%
Gold
/quotes/zigman/635641/delayed 1,282 +7 0.51%
Oil
/quotes/zigman/2196857/delayed 93.37 -0.59 0.63%
FTSE 100
/quotes/zigman/3173262/delayed 6,775 -2 0.04%
DAX
/quotes/zigman/2380246/delayed 9,339 -62 0.66%
CAC 40
/quotes/zigman/3173214/delayed 4,253 -40 0.93%
FTSE MIB
/quotes/zigman/1482176/delayed 19,918 -93 0.46%
IBEX 35
/quotes/zigman/2759620/delayed 10,500 -56 0.53%
Stoxx 600
/quotes/zigman/2380150/delayed 337 -1 0.23%
Asia Dow
/quotes/zigman/6959860/realtime 3,320 +11 0.33%
Nikkei 225
/quotes/zigman/5986735/delayed 15,539 -47 0.30%
Hang Seng
/quotes/zigman/2622475/delayed 25,112 +118 0.47%
Shanghai
/quotes/zigman/1859015/delayed 2,241 +10 0.46%
Sensex
/quotes/zigman/1652085/delayed 26,420 +59 0.23%
Singapore
/quotes/zigman/1709939/delayed 3,326 +1 0.04%
Euro
/quotes/zigman/4867933/realtime/sampled 1.32 0.00 0.30%
Yen
/quotes/zigman/4868099/realtime/sampled 103.94 +0.10 0.10%
Pound
/quotes/zigman/4867886/realtime/sampled 1.66 0.00 0.05%
Australia$
/quotes/zigman/4867876/realtime/sampled 0.93 +0.00 0.14%
DXY Index
/quotes/zigman/1652083/delayed 82.33 +0.17 0.21%
WSJ $ Idx
/quotes/zigman/9625991/realtime 74.53 +0.09 0.12%
U.S. 10yr
/quotes/zigman/15866666/realtime 2.41 0.00 0.07%
German 10y
/quotes/zigman/15866409/realtime 0.99 -0.01 0.75%
Italy 10yr
/quotes/zigman/15866497/realtime 2.58 0.00 0.17%
Spain 10yr
/quotes/zigman/15866444/realtime 2.39 +0.02 0.64%
U.K. 10yr
/quotes/zigman/15866328/realtime 2.41 +0.01 0.39%
Japan 10yr
/quotes/zigman/15866525/realtime 0.51 -0.02 3.97%
Crude Oil
93 -1 0.63%
Gold
1,282 +7 0.51%
Corn
/quotes/zigman/3098927/delayed 372 +3 0.88%
DJIA F
/quotes/zigman/21588489/delayed 16,999 -17 0.10%
S&P F
/quotes/zigman/20258909/delayed 1,988 -2 0.08%
Silver
/quotes/zigman/635603/delayed 19 0 0.16%

Markets News

  1. 14 min ago

    Dollar marks biggest weekly gain against yen in a year

  2. 25 min ago

    S&P 500 ends lower, pulling back from record

  3. 32 min ago

    SeaWorld shines, Green Mountain flexes muscle

  4. 49 min ago

    Treasurys mark largest weekly drop since July

  5. 58 min ago

    Salesforce, GameStop lead tech stocks

  6. 4:06 p.m.

    Newscast: Stocks up for week

  7. 4:03 p.m.

    Oil futures fall to cap a bearish week

  8. 2:58 p.m.

    RGSE falls 9%, bringing weekly losses to nearly 20%

  9. 2:42 p.m.

    Newscast: Stocks mixed, Keurig is piping hot

  10. 2:37 p.m.

    Gold up after losing streak, but down 2% on week

  11. 12:39 p.m.

    Hugo Boss climbs; oil stocks drop: Europe movers

  12. 12:35 p.m.

    Renewed Ukraine tensions push European stocks into the red

  13. 12:35 p.m.

    Newscast: Yellen speaks, no room for Jello

  14. 12:12 p.m.

    FTSE 100 ends choppy day lower as miners weigh

  15. 11:29 a.m.

    5 things to watch in Europe next week

Quotes

Symbol Price Change % Change
FB /quotes/nls/fb 74.57 0.00 0.00%
AAPL /quotes/nls/aapl 101.32 0.74 0.74%
GOOG /quotes/nls/goog 582.56 -0.81 -0.14%
BAC /quotes/nls/bac 16.13 -0.03 -0.19%
C /quotes/nls/c 50.93 -0.14 -0.27%
F /quotes/nls/f 17.17 -0.23 -1.32%
T /quotes/nls/t 34.50 -0.14 -0.40%
BP /quotes/nls/bp 48.13 -0.14 -0.29%
GE /quotes/nls/ge 26.15 -0.28 -1.06%
Visit the quote page and your most recently viewed stocks will automatically be displayed here.
Please log in to view your watchlist

World News from MarketWatch

Rates »

5 yr CD
1.4%
2 yr CD
0.9%
1 yr CD
0.7%
MMA $10K+
0.3%
MMA $50K+
0.6%

National averages from Bankrate.com

You Don’t Need Another Credit Card, You Need A Better One.
Avg. APR Last Week 6 Months
Low Interest 10.37% 10.37% 10.33%
Balance Transfer 12.64% 12.64% 12.66%
Business 12.80% 12.80% 12.98%
Student 13.27% 13.27% 13.27%
Cash Back 14.91% 14.91% 14.71%
Reward 15.00% 15.00% 15.03%
Airline 15.46% 15.46% 15.30%
Bad Credit 22.73% 22.73% 22.73%
Instant Approval 28.00% 28.00% 28.00%
Source:CreditCards.com
Trending Tickers
  • /quotes/zigman/30382045/delayed GMCR+13.26%
  • /quotes/zigman/18930420/delayed DRL-2.86%
  • /quotes/zigman/477117/delayed EJ+4.54%
  • /quotes/zigman/338061/delayed CRM+7.34%
  • /quotes/zigman/373855/delayed NSR+2.26%
  • /quotes/zigman/34694631/delayed INO+1.23%
X
Powered by StockTwits
Link to MarketWatch's Slice.

As of July 2, 2013, the SmartMoney content you loved now lives on MarketWatch.

MarketWatch will continue to provide the same important news and information you rely on every day. And, as a MarketWatch user, you will be able to enjoy:

  • Personalized news and quote email alerts
  • Editorial e-newsletters about personal finance, mutual funds and market-specific coverage
  • Premium newsletters by our market experts
  • Games, such as Virtual Stock Exchange and Beat the Darts
  • Free WSJ.com registration

Email address

Password

Forgot password?