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How to Choose a Plan

Before you choose your medical plan, take time to evaluate your needs, coverage options, and plan costs to ensure that you select the best plan for you.

Consider your health care needs

Your health care needs change throughout the years, and so should your benefits. The first step to making the best decision is to consider your health care needs for the upcoming year. This includes any planned procedures, specific health conditions you or your covered dependents have, and where you want to receive care. 

Understand your coverage options

When deciding which medical plan is right for you, it is important to understand the main features and benefits of Stanford’s four medical plan options. Use these resources to learn more:

Plans with a CopayPlans with a Deductible
Kaiser HMO (CA) | Kaiser HMO (HI) | Stanford Select Copay Health PlanStanford Choice High-Deductible Health Plan | ACA Basic HDHP
  • Preventive care is covered at no cost
  • Must choose a primary care physician (PCP) to oversee care and handle specialist referrals
  • In-network benefits only; no out-of-network coverage, unless in an emergency
  • Kaiser HMO is available in California and Hawaii
  • Flexible spending account (FSA)-eligible
  • Preventive care is covered at no cost
  • You pay the full cost for non-preventive medical care until you meet the deductible
  • No PCP is needed
  • No referral for specialists is needed
  • In-network and out-of-network benefits available, but you’ll save money staying in-network
  • Health savings account (HSA)-eligible*

*If enrolled in an HDHP, you may only participate in the Health Care FSA if you do not contribute to an HSA. 

Evaluate the costs

Your total costs include your employee contributions — what you pay for medical coverage — as well as what you pay out-of-pocket for services. 

A plan with lower monthly contributions and higher out-of-pocket costs might be the better choice if you are in good health and rarely see doctors. A plan that has higher monthly contributions but pays a higher portion of your medical costs may be better if you see specialists frequently or have been diagnosed with a chronic condition.