Health Insurance 101

Top Questions You Should Ask Yourself When Purchasing Health Insurance:

  • Ask friends and business associates what they do about health insurance.
  • Put some thought into your needs and the needs of anyone else who will be included in the insurance plan.
  • Do you or a dependent have any special health care needs to consider?
  • Find out about each type of group insurance, mainly HMOs, PPOs, POSs, and Health Savings Accounts.
  • When learning about each type of group insurance, compare whether you have a choice of doctors and how you would see a specialist, if needed.
  • Find out if your location would rule out one of the types of group plans.
  • Find out if there are enough health care providers close to you for the group network you are considering.
  • Think about any extra services you might need, such as therapy or equipment, and whether they are covered medical services.
  • Find out if a prescription plan comes with the group policy.
  • Note if one policy has more exclusions on medical services than the other. You may choose one type over another based on these exclusions and the comparative price of the premiums.
  • Find out how each plan deals with a possible dispute over a benefit.
  • Find out about individual health insurance, not forgetting that it is more expensive than group coverage. Sometimes individual insurance is your only option.
  • Make a comparison chart of your two final choices, listing the different costs of each of the following:
    1. Deductible for each individual
    2. Deductible total for the family
    3. Deductible for out-of-network providers (if different)
    4. Co-payment
    5. After deductible is met, percentage of fees paid by insurance company for network providers
    6. After deductible is met, percentage of fees paid by insurance company for out-of-network providers
    7. Maximum limit insurance will pay for each claim
    8. Maximum limit insurance will pay over one’s lifetime
    9. Uncovered medical expenses that will be out-of-pocket
    10. Can I afford the annual costs