- Out-of-pocket costs and doctor's office fees. If you expect to be in the hospital in the upcoming year for surgeries, birth, or any other reason, you may want to look for the plan with the lowest out-of-pocket maximum, and/or the lowest deductible. In most cases, plans with higher premiums will cover more of your costs and have a lower deductible, while plans with lower premiums will cover less and have a higher deductible.
- Prescription prices. Find out the full cost of any prescriptions you may have and compare the difference in cost to you over the year under each plan. The difference between co-pays and coinsurance in plans can make a big difference in prescription cost, which may be a bigger consideration for you than premium or deductible costs.
- Premiums. Ok, so you do have to take the premium into consideration, but it shouldn't be the deciding factor. Your total annual premiums should be factored in with your projected medical expenses and any funding you may receive through your employer via an Health Savings Account (HSA), Flexible Spending Account (FSA), etc.
- Your needs. The most important thing when selecting a health plan is to make sure that the things you need are covered. Do you see a specialist? Do you have any special medical needs or equipment? What benefits and exclusions are included in each plan? Will all of your needs be taken care of?
Some employers have tools for you to calculate your approximate cost under each plan, giving you a clearer picture of which one will be the best for you. Be sure to contact your human resources department; they can help you get the information you need in order to make the decision that's right for you.