Use the dropdown box to select Low, Medium, or High health care usage for each family member. Click on "health care usage" below to learn more about the different levels of usage. To customize the comparison for you and your family's health care usage, select the "Customize for you" tab and enter the frequency by medical plan service.
Or, you can choose to enter this information from a list of common medical services and supplies. Click "My own scenario."
New this year, the bar charts below show a side-by-side comparison of your total estimated expenses for 2016 and 2017 (split between your premium share and out-of-pocket expenses).
Important Note: Employee premium contribution share may vary depending on the employing agency or university. The premium contribution shares described below address most state agency employees. PEBB does not designate premium contributions. Contact your agency or university benefit office if you have additional questions about your premium contribution.
You pay either 1% or 5% of the total premium based on the medical plan you choose. Only full-time plans are available to full-time employees. When you enroll for either the PEBB Statewide Plan or the Kaiser HMO medical plans, you pay 5% premium contribution share. Enrollment in any of the other PEBB full-time plans will be a 1% premium contribution share.
The charts below don't account for items that are on the additional cost tier list which are not subject to the out of pocket maximum, but are subject to your plans maximum cost share. If you hover over the bars in the chart you can see the employee cost breakdown.
Use the sliders on the right to estimate your eligible expenses not covered by the plan for the upcoming plan year.
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Welcome to the PEBB Medical Plan Cost Estimator.
This tool shows you a personalized comparison of your 2017 total medical and pharmacy costs under each plan available in your area – the combination of your premium share and what you think you'll spend on deductibles, copays, coinsurance and other out-of-pocket costs. You might find that a different medical plan would meet your needs, but cost you less than the plan you're in today.
Keep in mind, however, that cost isn't the only consideration for choosing a medical plan. Before you enroll in a new plan during open enrollment, be sure to confirm it covers your preferred providers and the services and supplies you're likely to use in the coming year. Note to members who cover dependents who live outside a plan's service area: Ask the plan's customer service if your dependents will have access to in-network providers in the area where they live.
How it works
This tool is designed to help you choose the medical plan that's right for you in two easy steps:
Once you provide this information, you'll see an estimate of what you will spend for the upcoming year under each medical plan option – to help you identify your lowest cost option. Then you can use the results to decide if contributing to the Flexible Spending Account (FSA) is right for you.
Note: This tool does not show costs for dental, vision, the tobacco or spousal/domestic partner surcharge (if applicable).
We respect your privacy
None of the information you use to calculate your out-of-pocket costs will be tracked by the system, including your expected annual medical care expenses. When you leave the Medical Plan Cost Estimator, your information is immediately deleted. You can print your election scenarios from the Medical Plan Cost Estimator for future reference.
By using this tool, you are automatically agreeing that you understand and accept the following:
In the event of any conflict between the information contained in this tool and the plan documents, the plan documents shall govern in all cases.
This tool is designed to help you choose the medical plan that is right for you in two easy steps:
Then, you'll be able to see an estimate of what you'll spend annually for the upcoming year under each medical plan option. You can also use the Health Savings Account section to consider how much you should contribute on a pre-tax basis to cover your expected medical expenses.
This tool is designed for optimal performance in Internet Explorer 9 and later, and recent versions of Mozilla Firefox and Google Chrome. If you are using an earlier version or a web browser not listed, you may experience errors or be unable to use the tool correctly. In this case, please access the tool again using one of the listed web browser versions.
For optimal viewing, set the screen resolution to 1024 x 768 or higher.
This Medical Plan Cost Estimator is a financial comparison tool that allows you to estimate relative costs across your medical plan options. Estimates are based on national average medical cost data and may be higher or lower depending on where you live. Because costs vary by provider and not all Plan details are included, actual costs will vary from the costs the Medical Plan Cost Estimator provides. Actual costs may also vary based on the order in which services are incurred and by the specific family member using a service (if applicable).
In the event of any conflict between the information contained in this Medical Plan Cost Estimator and the plan documents, the plan documents will govern in all cases. To protect your privacy, your entries are not systematically tracked.
Use of the Medical Plan Cost Estimator does not enroll you in a medical plan or FSA.
To qualify for Favorable Deductions, both of the following must be true for you:
A premium surcharge applies if any of the individuals use tobacco.
Low health care usage means that you and your family typically only use your medical coverage for preventive care (i.e., some lab tests and preventive prescription drugs) and one or two doctor visits a year.
Medium health care usage means that you and your family see the doctor a few times a year for an illness, an injury or a chronic condition and incur prescription drug costs.
High health care usage means that you and your family use your medical coverage to manage a complex condition, injury or procedure that requires a number of doctors' visits, prescription drugs on a regular basis and perhaps an inpatient hospital stay, including a birth (regular or Caesarean delivery).