USA: Friendly Insurance Reminders and a Comparison Spreadsheet

Hi All,

It's that time of year again when we pick new plans or choose to stay with our current plan. I just thought I'd give a few friendly reminders and a spreadsheet I use to estimate costs of different plans.

Some of this, especially the spreadsheet, may be more geared toward type 1. But, it may be helpful for other types as well.

• Stock up on supplies.

  • Placing an end of year order can be a good idea to have somewhat of a stash going into the new calendar year.
  • Even if your insurance remains the same, things can change under the covers such as the formulary or rules for certain supplies. These can delay your first prescription refill. So, try to refill prescriptions early in the new year as well.
  • Also, since your deductible is almost certainly met now, if cashflow is an issue at all, having a stash of supplies may allow you to space out your first refills until your deductible is met for next year.

• When comparing policies, check the formularies. If there are two policies you're considering from different companies, it may be that one of them covers your preferred brands of insulin and test strips and the other does not. (Note: They may not have next year's formulary out before you have to decide.)

• When comparing plans, if you use an insulin pump and CGM, see if you can find out whether they cover the supplies as Durable Medical Equipment (DME) or as a standard prescription. The latter is probably better but less common in my limited experience.

• Healthcare.gov is already showing new plans. New York State of Health begins to let you see the new plans on Monday. I'm not sure about other states that may have their own exchange the way that New York does.

Below is a spreadsheet I created for my own personal use. It takes plan information such as premiums, max out of pocket, copays, deductibles, etc., and information about your personal health habits, numbers of prescriptions in each tier, number of office visits, cost of pump and CGM supplies, etc.

It then calculates an estimate of your total costs including the premiums and payments out of pocket. This allows you to compare plans to see which one is the cheapest in total cost for the year.

It currently compares 3 plans. With a little knowledge of spreadsheets you can modify it for more plans or modify the formulas for plans that don't fit my assumptions.

It's just a spreadsheet that you download to your local computer. So, no information is shared online.

I hope I've made the spreadsheet clear. Please do read the disclaimers as they list assumptions that I made.

Also note that I'm not offering to take any responsibility, especially financial responsibility, for any decisions made using this spreadsheet. I just find it useful and thought I'd share.

Let me know if you have any issues downloading or using the files. Let me know if you find any bugs.

I hope this helps to get the most effective insurance possible for the lowest price. No guarantees.

Health Insurance Cost Estimation - Microsoft Excel Version

Health Insurance Cost Estimation - Open Office Version

Hope this helps.