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How do I pick a health plan?

Whether your employer gives you a choice of plans or you need to purchase your own coverage, it is crucial that you understand your health insurance choices and pick the insurance that is best for you and your family.
Here are some questions you should ask yourself when choosing a health insurance plan:

How affordable is the cost of care?

  • What is the monthly premium I will have to pay?
  • Should I try to insure most of my medical expenses or just the large ones?
  • What deductibles will I have to pay out-of-pocket before insurance starts to reimburse me?
  • After I have met my deductible, what percentage of my medical expenses are reimbursed?
  • How much less am I reimbursed if I use doctors outside the insurance company’s network?

Does the insurance plan cover the services I am likely to use?

  • Are the doctors, hospitals, laboratories and other medical providers that I use in the insurance company’s network?
  • If I want to use a doctor outside the network, will the plan permit it?
  • How easily can I change primary-care physicians if I want to?
  • Do I need to get permission before I see a medical specialist?
  • What are the procedures for getting care and being reimbursed in an emergency situation, both at home or out of town?
  • If I have a preexisting medical condition, will the plan cover it?
  • If I have a chronic condition such as asthma, cancer, AIDS or alcoholism, how will the plan treat it?
  • Are the prescription medicines that I use covered by the plan?
  • Does the plan reimburse alternative medical therapies such as acupuncture or chiropractic treatment?
  • Does the plan cover the costs of delivering a baby?

*Information from Insurance Information Institute at www.iii.org