Health Insurance Worksheet For ________________________

This worksheet will allow you to compare different health insurance companies and plans to find the best one for your needs. Place a check in front of the services that are most important to you. Then, see how many of these services are available in Policy #1, Policy #2, and Policy #3. On the checklist, write in the coinsurance or co-payment rate, if there is one, and any limits on service. Remember that the most important service to be covered is hospitalization. If you are not covered for hospital care, then one sickness could cost you thousands of dollars, even hundreds of thousands of dollars. 

 

SERVICE

POLICY #1

POLICY #2
POLICY #3
Hospital Care      
Surgery (Inpatient)      
Surgery (Outpatient)      
Office Visits      
Maternity Care      
Well Baby Care      
Immunizations      
Mammograms      
Medical Tests, X-Rays      
Mental Health Care      
Basic Dental Care (Cleanings)      
Orthodontics (Braces)      
Vision Care (Eye Exams)      
Vision Care (Eye Glasses)      
Prescription Drugs      
Home Health Care      
Nursing Home Care      
Other Services (List Below)      
 
     
       
Choice Of Doctors      
Choice Of Hospitals      
Are Referrals Required?      
Ease Of Making Appointments?      
Pre-Existing Clauses      

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