What Questions Should I Ask When Buying Health Insurance?

Open Enrollment is now in full swing, and if you are thinking of taking out new coverage, now is the time to do your research. With the right health insurance policy in hand, you are better prepared for all that life throws your way. Your finances will be better protected and you can secure access to quality health care.

Even if you are content with your current health insurance plan, it’s a good idea to review your coverages and usage of services over the past year. It’s possible that some aspects of your current plan will have changed, and you should be prepared to find suitable coverage. To help you find the right policy for your needs, keep in mind these questions to ask when taking out health insurance.

What type of plan is it?
Most health plans fall into one of the two categories: Copay-based plans or Health Savings Accounts (HSA). While copay plans typically cost more per month and have lower deductibles, HSA plans have cheaper monthly costs and higher deductibles.

How much will I have to pay for medical care?
Take a look at the premium. Once you have a figure, then ask whether you will be charged a co-payment, a small flat fee, when charged for health care services. Some plans have a deductible instead, which is the amount you must pay before the policy starts to cover medical costs.

How much is the deductible?
If your plan has a deductible, find out what it is. If your deductible is $3,000, you will need to pay the first $3,000 for your medical costs before your insurance company will start contributing to your expenses. Be sure to research what costs count toward the deductible so you are prepared.

What is the difference between a deductible and a co-pay?
A deductible is something that you pay first before your health insurance starts to pay. A co-pay is usually a “per service” flat fee or percentage that you pay along with the insurance coverage for the service. An example is a $50 co-pay for x-rays or a doctor’s office visit. This paid each time you visit or have an x-ray. A deductible is only paid once per policy period.

What is the out-of-pocket maximum?
The out-of-pocket maximum is the most you can expect to pay before your remaining health expenses are covered in full by your insurance plan during the remaining policy year. Your deductibles, coinsurance, and copays all count toward the maximum. However, monthly premiums do not. If you are expecting a year with very high health care expenses (such as having a baby), then the out-of-pocket maximum is an important factor in selecting a health plan.

What are the plan’s restrictions on pre-existing conditions?
If you have a chronic condition, the policy may not cover related medical costs for a period of months – or, perhaps, ever. Be sure to ask for how long, if at all, pre-existing conditions are excluded.

What happens when I’m away from home?
If you need to go to the doctor while traveling, you should be aware of what costs will be included and if you will even be able to receive coverage.

Are my preferred doctors and hospitals in the network?
Keep in mind that the price for out-of-network care will always be at a significantly higher out of pocket cost, as these doctors and hospitals are not bound by your insurer to charge a set cost per service. Always check with your doctor or hospital before visiting if they are part of your insurance plan, to prevent surprise charges.

Is there a better plan out there for me?
Plans are always changing. Reevaluate your needs and look into options every year. You never know if a plan is better suited to your needs until you look.

Work with a qualified health insurance agent to find the right coverage for your needs. If you are unsure about how to get started on your health insurance policy, talk to the professionals at Lou Aggetta Insurance Services in Pleasant Hill. Our experts are ready and waiting to help you determine your health insurance needs and explain how a policy can protect your finances. Give us a call today to get started!