do I pick a health plan?
If 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.
are some questions you should ask yourself when choosing a health
How affordable is the cost of care?
is the monthly premium I will have to pay?
I try to insure most of my medical expenses or just the large ones?
deductibles will I have to pay out-of-pocket before insurance starts
to reimburse me?
Ive met my deductible, what percentage of my medical expenses
less am I reimbursed if I use doctors outside the insurance companys
Does the insurance plan cover the services I am likely to use?
doctors, hospitals, laboratories and other medical providers that
I use in the insurance companys network? ( For dental
plans click here.)
want to use a doctor outside the network, will the plan permit it?
can I change primary-care physicians if I want to?
need to get permission before I see a medical specialist?
are the procedures for getting care and being reimbursed in an emergency
situation, both at home or out of town?
have a preexisting medical condition, will the plan cover it?
have a chronic condition such as asthma, cancer, AIDS or alcoholism,
how will the plan treat it?
prescription medicines that I use covered by the plan?
the plan reimburse alternative medical therapies such as acupuncture
or chiropractic treatment?
the plan cover the costs of delivering a baby?
What is the quality of the insurance plan Im looking at?
independent government and non-government organizations rated the
plan? For example, the National Committee for Quality Assurance
( http://www.ncqa.org ) issues a Consumer Assessment of Health Plans
(CAHPS) report for every medical plan and facility.
kind of accreditation has the plan received from groups such as
NCQA or the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) ( http://www.jcaho.org )?
patient complaints were filed against the plan last year and how
many were upheld by state regulatory agencies like the state insurance
commission or the state medical licensing board?
members drop out of the plan each year? State insurance departments
keep track of disenrollment rates.
doctors, pharmacies and other services in the plans offer convenient
times and locations?
the plan pay for preventive health care such as diet and exercise
advice, immunizations and health screenings?
do my friends and colleagues say about their experiences with the
does my doctor say about his or her experience with the plan?