About This Estimator

The Medical Plan Estimator is designed to give you a general idea of what your costs might be under each of the options based on:

  • The services you think you and other covered family members will use.
  • The estimated cost of care in the geographic area you select, using discounted Preferred PPO rates for in-network care costs, and reasonable & customary (R&C) costs to determine the cost of care outside the network.

As you use the estimator and consider the results it provides, keep in mind:

  • The estimator applies costs to the deductible based on the coverage category you select. For example: If you select family coverage, all costs are applied to the family deductible instead of applying individual deductibles for each family member. This could overstate the amount that would apply to a family deductible and understate your coinsurance.
  • Plan limits and allowances are NOT considered. This estimator does not track individual limits on benefits, such as maximums for chiropractic care. Please study your grid to verify these limits.

When you finish estimating your medical costs, also use the results with PayFlex's Flexible Spending Account Calculator to help you decide whether a Health Care FSA makes sense for you.


Important Legal Information

The Medical Plan Estimator 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 Sandia's medical coverage options. Because costs vary by provider and not all option details are included, actual costs will vary from the costs the estimator 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).

In the event of any contradiction between the information contained in this estimator and the Plan Documents, the Plan Documents shall govern in all cases. Use of this estimator does not enroll you in a Medical Plan option or the Health Care Spending Account. To protect your privacy, your entries are not systematically tracked. Please remember to print any scenarios you want to look at later-your information is deleted when you close this window, click on "Reset" or go to another Web page.