There a many questions a consumer should ask when considering their health insurance choices. Some questions will be unique to an individual's current or anticipated healthcare needs and are difficult to address in this forum. However, in the era of ObamaCare, here are some general questions I think any health insurance buyer should be asking when looking at different health insurance carriers and different health insurance plans.
1) Would I qualify for a meaningful subsidy of my health insurance premiums if I purchase health insurance through a Federal or State health insurance marketplace?
2) What is the deductible and out-of-pocket maximum financial exposure I would have under a given policy?
3) Does the policy have copayments for visits to doctors, prescription drugs, urgent care and emergency room visits or are all or some of these commonly used services subject to the policy's deductible and co-insurance?
4) Are the doctors and hospitals I want to use in-network providers for the health insurance plan I am considering?
5) Are the prescription drugs I am taking covered under the formulary for the health insurance plan I am considering and, if so, what is the level of coverage and will I be subject to step therapy to gain access to a prescription drug I am already using successfully?
6) What coverage, if any, will I have if I choose to go outside of my health plan's provider network?
7) Are there any geographic service area restrictions to where my coverage applies?
8) Am I required to get a referral from a primary care physician before I can access care from a specialist or receive impatient or outpatient diagnostic services and treatment?
9) How financially stable is the health insurance carrier I am considering? This is especially important if you are considering enrollment in one of the new Co-Op health plans created under ObamaCare.
Obtaining answers to these questions that are satisfactory to you will go a long ways towards assuring that you get the kind of coverage that best suits your needs.
Seeking out the guidance of an experienced independent health insurance broker is generally these best way for people to get the answers to these and other questions they might have. Representatives of specific insurance companies can only explain their company's products to you and, of course, they will think that their company's plans are the best. The so called, navigators available to help people purchase coverage through the government marketplaces are rarely licensed insurance professionals, have little depth of knowledge in the industry and are generally reading from a script or are providing you generic answers that they have been provided with.
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1) Would I qualify for a meaningful subsidy of my health insurance premiums if I purchase health insurance through a Federal or State health insurance marketplace?
2) What is the deductible and out-of-pocket maximum financial exposure I would have under a given policy?
3) Does the policy have copayments for visits to doctors, prescription drugs, urgent care and emergency room visits or are all or some of these commonly used services subject to the policy's deductible and co-insurance?
4) Are the doctors and hospitals I want to use in-network providers for the health insurance plan I am considering?
5) Are the prescription drugs I am taking covered under the formulary for the health insurance plan I am considering and, if so, what is the level of coverage and will I be subject to step therapy to gain access to a prescription drug I am already using successfully?
6) What coverage, if any, will I have if I choose to go outside of my health plan's provider network?
7) Are there any geographic service area restrictions to where my coverage applies?
8) Am I required to get a referral from a primary care physician before I can access care from a specialist or receive impatient or outpatient diagnostic services and treatment?
9) How financially stable is the health insurance carrier I am considering? This is especially important if you are considering enrollment in one of the new Co-Op health plans created under ObamaCare.
Obtaining answers to these questions that are satisfactory to you will go a long ways towards assuring that you get the kind of coverage that best suits your needs.
Seeking out the guidance of an experienced independent health insurance broker is generally these best way for people to get the answers to these and other questions they might have. Representatives of specific insurance companies can only explain their company's products to you and, of course, they will think that their company's plans are the best. The so called, navigators available to help people purchase coverage through the government marketplaces are rarely licensed insurance professionals, have little depth of knowledge in the industry and are generally reading from a script or are providing you generic answers that they have been provided with.