Welcome!

This Medical Plan Cost Estimator is designed to help you make an informed choice about your medical coverage. Even if you are satisfied with your current coverage, you can use this tool to review your options for 2012-2013: PennCare/Personal Choice PPO, Aetna Choice POS II, Keystone/AmeriHealth HMO and Aetna High Deductible Health Plan with Health Savings Account (HSA).

For more information about the benefits described here, visit www.hr.upenn.edu or contact the Penn Benefits Center at 1-888-PENN-BEN (1-888-736-6236).

Penn's Medical Plan Cost Estimator Tool is based on:

  • The health care services you and other covered family members expect to use, and
  • The estimated cost of care in your region (using discounted rates for in-network costs and average costs to determine the cost of care for out-of-network providers, if applicable).

Keep in mind that this tool provides an estimate of your costs and not a precise calculation. Here's why:

  • Your actual cost will depend on the actual services you receive. This tool is unable to predict exactly what health care services you will need in the coming year.
  • The tool doesn't feature all possible services you could receive. To keep the tool simple and user-friendly, it includes a limited list of the most commonly-used services.
  • Plan limits and allowances are taken into consideration where feasible, but not for every service. Details are provided in the Medical Plan Cost Estimator Tool.

To access the Medical Plan Cost Estimator, click on the Get Started button above which will take you to the Preferences Tool. Once there, the questions and answers will help guide you toward the plan that is right for you. When you complete the Preferences Tool, proceed to the Medical Plan Cost Estimator. For additional information, please review the Important Enrollment Information and Questions to Ask Yourself sections by clicking the buttons below.

The Fine Print

Using this tool does not enroll you in a medical plan option. Penn’s Medical Plan Comparison tool is a financial comparison tool that allows you to estimate relative costs across your medical coverage options. Estimates are based on regional average medical cost data and most of the specific provisions of the medical plan options. Because costs vary by provider and not all option details are included, actual costs will vary from the costs the tool provides. Actual costs may also vary based on the order in which they are incurred and by the specific family member using a service (if applicable). If you use in-network preventive care as recommended by your plan, it is covered at 100% and will not impact your out-of-pocket costs and is therefore not included in the calculation.

In the event of any contradiction between the information contained in this tool and the plan documents, the plan documents shall govern in all cases. To protect your privacy, your entries are not tracked by the system. Please remember to print any scenarios you want to review later. If you click away from this page, no information will be saved.
Copyright ©2012 Mercer LLC, All Rights Reserved.

Important Enrollment Information

  • Review the pre-enrollment newsletter and Enrollment Guide you received from Penn.
  • Think about your needs and discuss your benefit options with your family. Determine how much health care—and what type of care—you think you will need for 2012-2013.
  • Before you enroll, ensure that your dependents are eligible for medical coverage.
    • Eligible children can be covered up to the end of the month in which they turn age 26.
    • Children are eligible for coverage regardless of their student, marital or IRS dependent status.
    • Children do not have to live with you or depend on you for financial support to be eligible.
    • Children over age 19 do not have to be full-time college students.
    • Disabled children who are unable to earn a living may be covered beyond age 26, provided the disability began before age 26 and has been certified by your insurance carrier.
    • Coverage does not extend to your child's spouse/same-sex domestic partners or children.
  • If you are considering enrolling in the Aetna HDHP with HSA, note that you are not permitted to use your HSA dollars on dependents over age 23 or same-sex domestic partners.
  • Attend an Open Enrollment Information Session and/or Benefit Fair to learn more about the 2012-2013 benefit options.
  • Ask questions throughout the enrollment process. Go to www.hr.upenn.edu or call the Penn Benefits Center at 1-888-PENN-BEN (1-888-736-6236).
  • Enroll before the end of your enrollment period (April 20, 2012).
  • Print and review your enrollment confirmation to ensure your benefit elections were recorded correctly.
  • If you enroll in the Aetna HDHP with HSA, look for your welcome kit in the mail.
  • If you enroll in a new plan, look for your new ID card(s) in the mail.

Questions to Ask Yourself

Evaluate Your Medical History & Future

  • How much health care—and what type of care—did I and/or my family need in 2011-2012? Did I/we need more or less health care than expected?
    • You can see your last two years of claims data online by visiting …
  • How much health care—and what type of care–do I think I will need for me and/or my family in 2012-2013?
    • Will my and/or my family's needs in 2012-2013 be similar to my/their 2011-2012 needs, or will I/we need more care?
    • Do I/we anticipate any significant health care needs, such as a scheduled surgery?
    • Do I/we have any ongoing health conditions for which care will be needed in 2012-2013?
  • Will the number of people I cover change in 2012-2013?
    • Is coverage scheduled to end for any of my dependents in 2012-2013?
    • Do I expect a major life event for me and/or my family in 2012-2013, such as the birth of a child?

Consider Your Preferences

  • How much freedom and flexibility do I need or want from my medical plan option?
    • Do I prefer to have the option to choose any provider without the need for a referral?
    • In which networks do my current providers participate?
  • How much of a role do I want to play in managing my health care costs?
  • How important is the payroll cost of my plan?

Plan for the Future

  • Do I have any other coverage available to me and/or my family members (e.g., through my spouse's or domestic partner's employer)?
  • Do I want a medical plan option that enables me to save for future health care expenses?

Preferences Tool

Take this quick quiz to determine which medical plan option has the features that are most important to you.

Plan feature Select the description that best matches your situation Medical plan option with feature that best matches your preferences
Cost of coverage
(biweekly payroll contribution)		 You would prefer to pay less per paycheck so that you do not pay for coverage you may not use.
 
You would like to balance what you pay per paycheck with what you pay out-of-pocket at the time of service.
You would prefer to pay more per paycheck to avoid having to pay more out-of-pocket when you need benefits.
Cost of care
(out-of-pocket expenses)		 You are comfortable with the risk of paying more out of pocket if you end up needing more health care than you think.
 
You are willing to pay a little more at the time of service, but would like financial protection from significant costs.
You avoid risk and would like to minimize your out-of-pocket expenses.
Cash flow
(when benefits are paid)		 You do not expect to use your medical coverage much. You are willing to pay a higher deductible and coinsurance if you need more care than expected.
 
You do not mind meeting a deductible before the plan pays benefits, but you want to minimize the amount of your deductible.
You would prefer to have the plan pay benefits right away, without having to meet a deductible.
Provider networks You want the freedom to choose physicians and hospitals from inside or outside a network each time you need care. You do not mind paying more out-of-pocket for this freedom.
 
You know you need to receive out-of-network care, so you want a plan with out-of-network benefits. You would also like to minimize your out-of-pocket expenses if you use an out-of-network provider.
You are content to limit your providers to a specified network.