| Comparing Health Plans |
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| Questions to Ask |
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No matter what type of plan you are considering, here are key questions to ask:
- What is my monthly premium? This is the dollar amount you pay to have health insurance regardless of whether you use medical services. However, the lowest premium isn't always the cheapest plan. Typically, the higher the monthly premium you pay, the less you will pay per doctor's visit in co-payments and deductibles. If you choose a health insurance plan with a low monthly premium, you're likely to pay more when you use medical services. If you visit the doctor often, this may not be the least costly plan.
- What are my out-of-pocket costs (coinsurance, co-pays, and deductibles)? These are your costs when you use health care services.
- What is covered/not covered? All contracts list "exclusions and limitations." For example, the contract may not cover cosmetic procedures, experimental treatments, acupuncture, or drug abuse/addiction treatment. Optical and dental services may not be covered, especially in individual and family plans. You may need to be insured for a certain period of time before transplants or tonsillectomies are covered. These are just examples. A typical contract has even more "exclusions and limitations."
- Do I pay less if I use certain doctors/hospitals under contract to your plan? If keeping your same doctor is important, find out if your doctor is part of that network.
- Do I need prior approval to see specialists?
- Who can I see after hours and for emergency care?
- When are my pre-existing conditions covered?
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