Health Insurance Worksheet

Help for people new to health insurance

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Health Insurance 101 Worksheet

Use this worksheet to get organized before shopping for health insurance. Fill in each section so you can compare plans with confidence.

1. Personal Information

  • Name: __________________________
  • Age: __________________________
  • Household Size: __________________________
  • Dependents (Spouse/Children): __________________________

2. Current Coverage

  • Do you have insurance now? Yes / No
  • If yes, what type? Employer / Marketplace / Medicaid / Medicare / Other
  • When does it end (if expiring)? __________________________

3. Healthcare Needs

  • Doctors or specialists you need covered:
    __________________________________________
  • Medications you take regularly:
    __________________________________________
  • Expected medical services this year:
    (e.g., surgery, maternity, mental health)
    __________________________________________

4. Budget

  • How much can you pay monthly? $__________________________
  • How much could you afford for an emergency bill (deductible)? $__________________________
  • Preferred balance: Lower monthly cost / Lower out-of-pocket cost

5. Plan Comparison

When reviewing plans, fill in the table below:

Plan NameMonthly PremiumDeductibleDoctor NetworkPrescription CoverageNotes
________________ $__________ $__________ Wide / Limited Yes / No ________________
________________ $__________ $__________ Wide / Limited Yes / No ________________

6. Questions to Ask

  • Are my doctors in-network?
  • Does this plan cover my medications?
  • What’s the max out-of-pocket cost?
  • Is preventive care free?
  • Does this plan qualify for government help or discounts?

Tip: Bring this completed worksheet when talking to an insurance agent or using an online marketplace. It will save you time and help you avoid costly mistakes.

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