Insurance Comparison Worksheet
| Plan A | Plan B | ||
| Type of plan | ___________________ | ___________________ | |
| Total premium/month | ___________________ | ___________________ | |
| Your portion of premium/month | ___________________ | ___________________ | |
| Your portion of premium/annually (monthly x 12) | ___________________ | ___________________ | |
| Yearly deductible | ___________________ | ___________________ | |
| Maximum out-of-pocket | ___________________ | ___________________ | |
| Maximum benefit: | |||
| Yearly | ___________________ | ___________________ | |
| Lifetime | ___________________ | ___________________ | |
| Co-insurance or copayments | ___________________ | ___________________ | |
| Services: which are most important to you? | |||
| Hospital Care | ___________________ | ___________________ | |
| Surgery (inpatient and outpatient) | ___________________ | ___________________ | |
| Office Visits | ___________________ | ___________________ | |
| Medical Tests and X-rays | ___________________ | ___________________ | |
| Prescription Drugs | ___________________ | ___________________ | |
| Maternity Care | ___________________ | ___________________ | |
| Well-Baby Care | ___________________ | ___________________ | |
| Immunizations | ___________________ | ___________________ | |
| Mental Health Care | ___________________ | ___________________ | |
| Drug and Alcohol Abuse Treatment | ___________________ | ___________________ | |
| Physical Therapy | ___________________ | ___________________ | |
| Chiropractic Care | ___________________ | ___________________ | |
| Transplants | ___________________ | ___________________ | |
| Vision Care | ___________________ | ___________________ | |
| Skilled Nursing Care | ___________________ | ___________________ | |
| Emergency Care | ___________________ | ___________________ | |