The Right Health Care Plan Questions to Ask
Buying health insurance or a health care plan for you or your family is a big transaction not only for you but for the company selling it as well. That's why many encourage a ‘Don't Ask, Don't Tell' policy among their sales people. You probably won't get the right answers you need unless you ask all the right questions. Here are some basic ones to help you get started.
Who are the health care providers and specialists on the list? Insurance companies have a list of approved or accredited medical centers and doctors. See if your family physician or preferred specialist is there, or at least ensure that there are some hospitals from your area.
How much will it cost to use an out-of-network provider? The answer to this question will tell you how much flexibility you'll have with your plan. Some companies partly cover expenses while some don't cover anything at all.
Does the plan cover regular checkups? You'll probably get a few physicals or routine checkups throughout the course of a year. They cost money but, with any luck, the provider will pay for them.
What part of the cost of prescription drugs does the health care plan cover? Prescription drugs can get really expensive and some insurance companies don't cover the entire cost.
Are pre-existing conditions covered by the plan? Some companies don't cover conditions that began or were diagnosed before the plan took effect. Birth defects and chronic conditions fall under the category of the question.
How much does the plan cover for emergency care? This is a particularly important question to ask. The cost of emergency care could be as high as triple or quadruple that of regular care. Not all insurance companies also cover the entire cost, if any.
Are you covered by the health care plan when you travel? You'll most probably do a bit of traveling while the plan is still in effect. The coverage from some companies automatically stops when you leave the city, state or country. Check to see if the plan can cover your costs, even when you're away from home.
Does the plan cover prenatal and childbirth costs? Like emergency care, prenatal and childbirth care could run up to big bills, and not all insurance plans cover them. If there's anyone in the family who might be having a baby anytime soon, it's an important question for you to ask.
Are there costs not covered by the health care plan? Do you have to pay anything before the company starts footing the bill? There are oftentimes a lot of exclusions to a health insurance plan. Make sure you get an itemized list of all of them to see if any of the exclusions will have a big impact on you. Copayment plans are also common elements in a health plan. Get all the payment arrangements clear before deciding anything.
Will the plan cover extra services? The treatment or therapy could extend well beyond the hospital. Ask if the health care plan will cover things like mental therapy or nursing services.
