Start with the risk you want to transfer
Accident-only coverage protects a narrower set of sudden injuries. Accident-and-illness coverage adds new illnesses. Wellness benefits usually budget for routine care rather than catastrophic medical risk.
Set the annual limit
Ask how much of a major surgery, hospitalization, cancer treatment, or recurring chronic illness you could pay without insurance. A low annual cap can be exhausted quickly in a severe year.
Choose deductible and reimbursement together
A higher deductible can lower premium; a higher reimbursement percentage can raise it. Run the same sample bill through several combinations before choosing.
Do not ignore exclusions
- Pre-existing conditions
- Waiting periods
- Orthopedic or bilateral rules
- Dental illness
- Exam fees
- Prescription medication
- Rehabilitation
- Condition or benefit sublimits
Worksheet
| Decision | Your choice |
|---|---|
| Plan type | |
| Annual limit | |
| Deductible | |
| Reimbursement percentage | |
| Must-have benefits | |
| Maximum monthly premium you can sustain |