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5 Things You Should Know Before Choosing a Health Insurance Plan

Modern Times Jul 15, 2019
Choosing a health insurance plan can feel daunting at first. The sheer number of options available can feel overwhelming, but the right information can demystify the process. You'll have an easier time selecting health coverage for you and your family by answering these five basic questions.

Are Preferred Providers Covered?

Check if your hospitals, pharmacies, and health care providers fall under the plan’s network. So if there’s a healthcare center in Salem, NJ you’re loyal to, make sure they’re in the network. In-network services and medicines are covered under the plan while out-of-network services and medicine aren’t covered.

How Much Do You Pay Out-of-Pocket?

If you have a $1,500 deductible, your health plan won’t cover medicine or services until you’ve paid $1,500. Out of pocket expenses include primary care visits, procedure fees, and prescriptions. Check your policy to see if medical and pharmacy services are bundled, or if medicines are a separate deductible.

How Much Will You Pay Monthly?

A premium is the monthly amount you pay the insurance company for coverage, even if you don’t use any medical and pharmacy services that month. High-deductible plans typically have lower monthly premiums, while plans with low deductibles have a higher monthly premium.

Are Your Prescriptions Covered?

Companies use formularies, a list of prescriptions that are covered by the insurance plan. Drugs on the list are also divided by tiers which determine how much you’ll have to pay. Create a list of your current prescriptions and compare it to the plan’s formulary to verify if your meds are covered.

Know Your Co-Pay

A co-pay is a flat fee that patients pay out-of-pocket for prescriptions and medical services like emergency room visits, doctor appointments, and specialist visits. Insurance plans determine these fees and the amount is usually printed on your insurance card.
Selecting an insurance plan is an important health decision for you and your family. By answering these five questions, you’ll feel better equipped when shopping around for an insurance plan.