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Ten Questions to Ask Before You Choose a Health Plan

Your health is your biggest asset. Every goal in life can only be accomplished, and its results only enjoyed if you are healthy. Yet, many continue to take their health for granted.

For instance, according to data collected by CDC as part of its National Health Interview Survey, over 30.1 million US citizens above the age of 65 and 11.5 percent of those under 65 are uninsured.

Health insurance is a crucial step in safeguarding your health. This is because, when things go south, health coverage makes sure that you can get the required medical care without any financial constraints.

If you are among those who are yet to choose a health plan, it is time you consider it. Ask these ten questions to your healthcare insurer before selecting a plan.

1. What is the type of plan offered?

Health plans can be divided into two broad categories, namely indemnity health plan and managed care system.

In the former, the patient must pay a given percentage of the medical expenses while the insurance company pays all the remaining percentage. Here, you are allowed to select your doctors.

In the managed care system, if you opt for corporate insurance, your employers pay a monthly fixed fee for the health care services. Therefore, your out-of-pocket expense is minimal. However, the catch is that you must only consult doctors mentioned in the plan.

2. How much healthcare cost will you have to bear?

Generally, no healthcare plan offers complete medical expense coverage. Instead, there is a certain amount of money that you have to pitch in as well. Such out-of-pocket expenses include deductibles and coinsurance, etc.

Make sure that you are well aware of the amount of these charges, as well as the percentage segmentation of the overall expense.

3. What is the cost of the plan?

Regardless of the type of health plan you are buying; you always have to pay a monthly premium to the insurer for keeping the insurance active.

This holds in health plans as well. The amount of premium charge will vary depending on your coverage, type of plan, etc.

4. What does the plan cover?

The last thing you would want is to find out at the last moment that your health plan doesn’t cover a given healthcare service.

Therefore, ask about it upfront. Coverage may or may not include lab tests, hospitalization charges, post-hospitalization expenses, prescription drugs, etc.

Also, ask about policy exclusions. This refers to any treatment or diseases that are not included in the plan.

5. What are the restrictions on the health plan?

Some health plans don’t cover chronic conditions that you either experience or have the genes for, for a given period of time. This is done by insurers to mitigate risk.

Ask if there are any such limitations to the plan and for how long your pre-existing condition will remain excluded. This will help you decide whether the said coverage is worth it or not.

6. Are routine tests covered?

Specific ailments and conditions require patients to have several routine tests. Sometimes, these tests tend to be pricier than the cost of seeing a doctor. Inquire if the plan provides coverage for the routine tests.

7. How is the premium determined?

Different factors come into play when determining a premium for a given person. For starters, your age and current health play an integral role.

The older and more prone to diseases you are, the higher your premium will be. Ask for clarity regarding the deciding factors and why a given premium is being charged. For instance, despite your age, you can argue that your favorable medical history should lower your premium.

8. How do you file a claim?

Right from the start, be clear about the technicalities. Since emergencies don’t come with a warning, it is better to be prepared.

It understands the process of filing a claim. Know what documents you will need to submit to initiate the claim.

9. What is the limit of claims you can make?

Some health plans come with a limit of claims you can make annually. Others limit healthcare expense disbursement via providing a given sum of money that you must not exceed.

Regardless, the fact remains that you cannot get unlimited coverage with any plan. Know the claim limit of a given insurance plan and select one which best suits your healthcare needs.

10. What doctors will you be able to consult?

Some plans come with limits when selecting hospitals and doctors. This also depends on the type of plan you select.

If you are picky about where you wish to get your treatment from, first ask for the list of hospitals and doctors that are provided under the healthcare plan.

Ending Remarks

Do your research by asking these ten questions. The answers you get from insurance companies will help you analyze which insurance plan is ideal for you.

Make sure you understand the health plan you select. Go through the wordings of the policy documents carefully before signing it. In case of confusion, don’t shy away from asking. Make an informed decision. After all, this involves your health, and you should take no chances on it!

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