Questions You Should Ask When Choosing a Health Insurance Plan

Choosing the right insurance plan can be difficult, especially when you aren’t used to all the jargons. In many cases, health insurance providers will take advantage of unsuspecting clients and will offer plans that will benefit the company first, not the client. However, there are some specific questions you can ask if you don’t know if a plan is right for you. Here are a few of them.

What Type of Plan Am I Choosing?

The first thing you should know is whether you’re choosing a managed care system or an indemnity health plan. With indemnity plans, which are also referred to as fee for service plans, you will usually have to cover some of the costs. The insurance company will be in charge of covering the rest. And you will usually have the choice of doctors.

When it comes to managed care, whether through a health maintenance orgaonization or by working with a preference provider organization, the out of pocket costs are kept to a minimum. Yur employer will usually be in charge of covering most expenses on a monthly basis, but the catch is that you’ll have to use providers that are affiliated with the HMO. Through a preferred provider organization, your employer will get a preferential deal with a certain group of physicians. You’ll have the choice to choose a service provider outside of the PPO, but the costs will be higher.

How Much will I Pay?

The next thing you should be asking is how much the premium will be. The next question would be how much of a flat fee you will have to pay for services and whether you will be charged with a co-payment. In some cases, a small flat fee will be required for health care services.

Other plans work with deductibles and you will have to pay a certain amount before you’re even eligible for coverage. It is extremely important that you aware of how much deductible you have to pay to know if you’re covered. Other health plans, such as those offered by Pivot Health, offer short term options and deductibles are usually lower in these cases

What Medicine is Covered?

This may come as a surprise for some, but not all medicine is covered by most health plans. Before you decide to sign up for a health plan, you have to make sure that the plan will cover the medicine you need, when you need it and at affordable costs.

You should be asking how much you’ll be expected to pay monthly for your prescriptions. You also have to know what your options are in case a particular treatment isn’t covered. Another question you should ask is which pharmacies you can use. Through some health plans, you’re only allowed to go to specific pharmacies, which could complicate things depending on where you live.


All these questions should be addressed before you sign up for any health plan. Make sure you understand how you will be covered, how much you will be expected to pay as far as premiums and deductibles go and what treatments will be covered.


Article Submitted by Community Writer

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