Medical Plan Cost Estimator

For many people, cost is one of the key factors in choosing a medical plan. The Choose Well, Use Well Medical Plan Cost Estimator is specially designed to help you estimate that cost – looking at both:

  1. What you are likely to pay for the services and supplies you need during the year
  2. The amount that comes out of your paycheck when you enroll in an EHS medical plan.

Using the Medical Plan Cost Estimator

Complete the following information, including your level of coverage and scheduled weekly work hours (maximum 40), then estimate the number of times you and your family will be using each service during the year. For example, if you and your spouse both will be covered, and you estimate that you will each have 2 specialist office visits in the plan year ending 6/30/15, enter “4” next to specialist office visits.

To protect your privacy, your entries are not systematically tracked or saved. 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.

Please enter whole numbers only (no commas, decimals, or special characters).

Step 1
Your Information (all fields are required)
Level of coverage
Employment Status
Your scheduled weekly work hours (maximum 40 hours)
Will you be participating in the new incentive plan, in which EHS will contribute up to $250 per person with a maximum of $750 per family into a Health Reimbursement Account (HRA)?

Step 2
Enter Your Anticipated Medical Needs for the Plan Year Ending 6/30/15
Medical Service Cost Range* Total Number of Times Covered Individuals Will Use the Service
Outpatient Care
Well care/GYN exam $60 - $85
Pediatric office visit $60 - $80
Diagnosis/treatment office visit $70 -$90
Specialist office visit $70 -$90
Mental health/substance abuse office visit $55 - $70
Chiropractic visit $50 - $65
Physical therapy visit $80 - $95
Mammogram $40 -$85
X-ray $80 - $120
Cholesterol screening $100 - $350
Colonoscopy $500 - $800
Arthroscopy $3,000 - $10,000
Emergency room visit $85 - $165
MRI, MRA, CAT Scans, or PET Scans $500 - $1,000
Blood test $20 - $40
Inpatient Care
Maternity - normal delivery $2,100 - $3,100
Maternity - Cesarean delivery
(including 2-day hospital stay)
$9,500 - $13,500
Two-day non-maternity hospital stay
(hospital charges only)
$4,000 - $6,000
Joint replacement (hip or knee) $6,000 - $24,000
Prescription Drugs
At pharmacy - generic (30-day supply) $25 - $30
At pharmacy - preferred brand name (30-day supply) $115 - $125
At pharmacy - non-preferred brand name (30-day supply) $90 - $105
Mail order - generic (90-day supply) $75 - $90
Mail order - preferred brand name (90-day supply) $345 - $375
Mail order - non-preferred brand name (90-day supply) $270 - $315

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


*These are the average medical costs in New Hampshire.