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Medical Insurance
Choosing Medical Insurance
If your employer offers you a choice of medical insurance plans or you need to purchase your own coverage, it is extremely important that you understand your medical insurance choices and pick the insurance that is best for you and your family.
These are some questions to ask yourself when choosing a medical insurance plan:
How affordable is the cost of care?
- What monthly premium I will have to pay?
- Should I try to insure most of my medical expenses or just the large ones?
- What out-of-pocket deductibles will I have to pay before insurance begins to reimburse me?
- What percentage of my medical expenses are reimbursed after I’ve met my deductible?
- How much less am I reimbursed if I use doctors outside the insurance company’s network?
Does the insurance plan cover all or most 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?
What is the quality of the medical insurance plan I’m looking at?
- How many 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?
- How many members drop out of the plan each year? State insurance departments keep track of “disenrollment rates.”
- Do the doctors, pharmacies and other services in the plans offer convenient times and locations?
- Does the plan pay for preventive health care such as diet and exercise advice, immunizations and health screenings?
- What do my friends and colleagues say about their experiences with the plan?
- What does my doctor say about his or her experience with the plan?
See also:
Health Insurance Terms
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