It can be a headache when searching between multiple health care plans. Below you will find ten areas to keep in mind when looking for a new provider:
1- Health Problems: If you have pre-existing conditions can vary from plan from being covered completely, excluded all together or existing health problems may be covered after a certain amount of time. If you have an existing condition you are protect by the Health Insurance Portability and Accountability Act if you are joining a new plan from your employer and if you were previously insured.
2 – Screenings: Some Independent insurance plans do not cover screenings. Check before you joining. Also check to see if your children will be covered for such things like immunizations.
3 - Current Doctor: Find out if you can use your current doctor. Some health plans require you to use doctors within a netowork. If you have to find a new doctor, you might want to research their background. A good place to check a doctors creditionals is with the AMA.
4 - Specialists: Find out what the rules are in using a specialist. A lot of providers require you to contact your primary care physician before you are able to be seen by a specialist. You don’t want to be caught having to foot the bill just because you saw a specialist first.
5 - Emergency Care: Find out what hospitals are covered for emergency care. You will need to see what is considered an emergency. Also you will want to find out if you have to contact your physician.
6 - Obstetrician or Gynecologist: You will want to see what may be covered. A lot of plans are now types of fertility coverage. With pregnancy coverage you need to find out how much you will have to pay for pregnancy and birth care if you are pregnant or decide to get pregnant in the future. This would be your out of pocket expenses.
7 - Coverage of Drugs: Variations in plans can be dramatic when it comes to prescription drugs. If you rely on prescriptions you MUST check with your new provider first to see what is and isn’t covered.
8 - Add Ons: Check to see what additional services might be available to you. Some services might be: counseling, mental health care, experimental treatments, alternative treatments, and nursing home care.
9 - What is Excluded: It is important that you find out what is not included. If you have any current conditions you will want to see if it is on the list or not.
10 – Finally, What is the costs: Now that you have an idea of what you need in a health care plan, you will want to compare prices. You will need to find out what kind of deductibles need to be paid for regular office visits, emergencies, surgery and any other kind of procedure. Find out the percentage you will have to pay after the deductible. And you will need to know the percentage you will have to pay for a specialist or out of network doctor.
Most importantly, if you are confused about coverage ask the representative to explain it to you, which is their job.
