Step 1: Tally last year's care
Add up doctor visits, prescriptions, and procedures. This is your real usage profile, not a guess.
Step 2: Total cost, not premium
Add premium + expected out-of-pocket for each plan option. The cheap-premium plan often loses to a moderate-premium HMO once usage is included.
Step 3: Confirm doctors and drugs
Each plan has its own network and formulary. Check both before switching.
Step 4: HSA opportunity
If a high-deductible plan is offered, calculate the tax savings of maxing your HSA — often the deciding factor.
Key takeaways
- Use last year's actual usage, not assumptions.
- Compare total cost, not just premium.
- Verify networks and drug formularies.
- HSA contributions can swing the math.
This article is for general educational purposes and is not legal, financial, or insurance advice. Consult a licensed professional for decisions specific to your situation.