Medical Plan Estimator

California

Step 1
Your Information (all fields are required)
Are you covering a spouse?
How many dependent children are you covering? (maximum of 3)
Retiree status
Retired before 1995
Retired between January 1, 1995 and December 31, 2002
Retired after December 31, 2002 with more than 30 years of service
Retired after December 31, 2002 with 25 - 29 years of service
Retired after December 31, 2002 with 20 - 24 years of service
Retired after December 31, 2002 with 15 - 19 years of service
Retired after December 31, 2002 with 10 - 14 years of service


Step 2 (optional)

Choose a general health status for each eligible person covered under your Sandia medical plan – for yourself, your spouse, and up to three dependent children.
Select the Health Status
Self Spouse Child 1 Child 2 Child 3


Step 3

Use the columns below to specify exact medical service usage for each eligible person individually. If you’ve selected a general health status above, you can modify the pre-defined scenario below.

Please enter whole numbers only. Do not use commas, decimals, special characters, or negative numbers.
Your Anticipated Medical Needs for 2010
Medical Service Cost Range* Total Number of Times You Will Use the Service Total Number of Times Your Spouse Will Use the Service Total Number of Times Child 1 Will Use the Service Total Number of Times Child 2 Will Use the Service Total Number of Times Child 3 Will Use the Service
Preventive Care
Adult Routine physical $145 - $210
Well child exam $120 - $180
Immunizations/flu shots $15 - $30
Cholesterol screening $40 - $60
Colonoscopy $1,500 - $3,300
Bone Density $300 - $1,800
PAP test $65 - $90
PSA test $35 - $125
Mammogram $210 - $390
Outpatient Care
Office - PCP visit $75 - $120
Office - Specialist visit $300 - $500
Urgent Care $200 - $400
Emergency room visit $450 - $1,100
Outpatient surgery $3,500 - $8,000
Allergy treatment - testing $220 - $400
Allergy treatment - serum $450 - $850
Allergy treatment - shots $40 - $65
Chiropractic /Acupuncture $105 - $145
Physical/Occupational/Speech Therapy $180 - $250
Lab/ Radiology
Blood Test and Platelet count $15 - $60
Biopsy $110 - $225
Lipid Panel $35 - $160
Comprehensive Metabolic Panel $50 - $100
Coumadin Check $15 - $100
X-Ray $70 - $250
MRI $1,550 - $3,400
CAT Scan $300 - $1,100
Other Lab/Radiology expenses for covered services under the medical plan Enter dollar amount
Hospital Services
Inpatient $20,000 - $60,000
Ambulance $500 - $600
Other Benefits
Durable Medical Equipment Expenses for Covered Services Enter dollar amount
Prescription Drugs — Retail (per 30-day supply)
Generic $25 - $35
Preferred brand name $125 - $165
Non-preferred brand name $120 - $250
Prescription Drugs — Mail Order (per 90-day supply)
Generic $80 - $110
Preferred brand name $320 - $420
Non-preferred brand name $370 - $470
Behavioral Health
Outpatient visit $80 - $150

Calculate and view results below, or reset the worksheet and model a new scenario. To modify a current scenario, simply adjust the numbers above and click the Calculate button.

   


Without coverage, your total medical expenses for CY 2010 based on reasonable and customary charges (not group medical plan network negotiated fees) are estimated to be: $

*These are the average medical costs (called "reasonable and customary") in your geographic area.