Health Plan Evaluation Checklist


Fill out the following checklist to 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

Avoid financial surprises by knowing what the out-of-pocket expenses are. In addition to the monthly premium, review the co-pay and deductible amounts.

What is the monthly premium? ________

What is the deductible?________

How much is the co-payment?________

What is the co-insurance percentage?________

Will you have a claim form to complete?________

Choosing a Provider

Research your healthcare system's physician network to ensure your doctor is an accepted provider under the insurance plan. Also consider any health needs that may require a specialist and verify that the physician also is eligible on your plan.

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

a primary care physician___________________________________


an urgent care center___________________________________

a hospital___________________________________

Evaluating Your Coverage  

Evaluate the coverage to ensure your family's care can be met. Whether you are just starting a family, have school-age children or nearing retirement age.

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 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)

(This information is provided by Baptist Medical Group for informational purposes only. Your decision regarding health insurance should be based on your particular situation. If you need advice, you should contact your insurance advisor.)