Choosing health benefits can be a complex process, but planning well can make a big financial difference. Use this checklist to make sure you know what you’re buying. Be sure to read the fine print carefully. Some of these answers may be provided in the materials you received. Don’t be shy about asking for information or answers you can’t find.
What will the plan cost?
- What is the monthly premium?
- What are my co-pays or coinsurance with this plan?
- What is my deductible?
- After I’ve met my deductible, what percentage of my medical expenses is reimbursed?
- What is my maximum out-of-pocket cost?
Does the plan cover the services that are important to me?
- Are the doctors, hospitals, laboratories and other health care providers that I use in the plan’s network?
- Am I allowed to see a doctor outside the network? If so, how much will the plan pay toward my costs?
- How easily can I change my primary care physician?
- Do I need to get a referral from my primary care doctor to see a specialist?
- What are the procedures for getting care and being reimbursed in an emergency, at home or out of town?
- If I have a chronic condition such as asthma, cancer, or diabetes, what special services or programs are offered to me?
- Are the prescription medicines that I use covered by the plan? What will they cost me?
- Does the plan reimburse alternative medical therapies such as acupuncture or chiropractic treatment?
- What additional programs and services does the carrier offer (i.e., wellness programs, weight management programs, programs for chronic diseases, tools to help me learn the cost of care before I receive it)?
If you’re in a new job, make sure to confirm when you will be eligible for benefits, and when your coverage will begin.
Click here for more tips on choosing benefits.