Questions to ask when choosing a health insurance plan

Choosing a health insurance plan can be downright complicated. There are many things to consider beyond what you’ll pay in premiums.

Here are a few questions you should ask your insurance agent when choosing a health insurance plan.

What is covered?

One of the first things you should ask is what is actually covered by your plan. At a minimum, most plans will cover outpatient care, emergency room visits, in-patient care in the hospital, pre-and post-natal care, prescription, drugs, treatment for chronic conditions, lab tests, pediatric services and preventative services such as vaccines. Depending on your state of health and any conditions you may have, you should be especially careful to choose a plan that will apply to your family’s needs.

What is the most you’ll pay for care?

Health insurance plans have an out-of-pocket maximum, which pertains to all types of services and doctor networks. If you’re concerned about a potential need for surgery or if you have ongoing medical needs, you’ll want to make sure that your out-of-pocket maximum amount is something you can afford.

What are the prescription costs?

Depending on your health condition, prescription drug costs can add up quickly. You’ll want to make sure that whatever prescriptions you and your family need are adequately covered by your insurance plan. Otherwise, you could be faced with prescription drug costs that might land far outside your budget.

Doctor networks

You should always look at the network of doctors your plan covers. Smaller networks are typically less expensive because the insurer will have an arrangement with a particular group of doctors.

Some plans, like Health Maintenance Organizations (HMOs), will only provide coverage for a select group of approved doctors, and will often require approval to see a doctor outside of the network. HMOs are generally cheaper than Preferred Provider Organization (PPO) plans, which let you choose your own doctor. You may want to consider a PPO plan if you have a trusted doctor you have been with for many years whom you’d like keep seeing without incurring extra out-of-network costs.

Out-of-network plans cover doctors outside of the network, but even with approval, the costs can add up quickly.

It’s always best to speak with an expert to make sure you choose the plan that is right for you and your family. An insurance agent at John B. Wright Insurance can help you to choose a policy that not only offers the best coverage for your family but won’t break the bank.