8 Questions to Ask When Considering Health Insurance

We are so thankful for our ability to help the working uninsured in our community. Their health is our #1 priority. Everything we do is free to the patient- medications, patient visits, screenings, and more. One challenging part of the work we do is that if at any point our patients obtain health insurance, we are no longer able to be their primary care provider. Health insurance is a wonderful thing; however, sometimes fees can be high. We have put together a few things to ask any health insurance company or anyone offering you free health insurance:

1.Will this health insurance plan help me save money if I’m healthy?

  • How much will I pay each month (monthly premium)?

  • How much will I pay to see my doctor, visit urgent care, go to the emergency room or fill prescriptions (copays)?

  • If I get the same care as last year, what would it cost?

  • Can I really afford the plan?

2. Will this health insurance plan be affordable if I’m sick?

  • How much will I have to pay before the plan starts to help (deductible)?

  • What’s my share of the cost of other care, like getting an X-ray or staying in the hospital (coinsurance)?

  • What’s the most I’d have to pay for care next year (out-of-pocket maximum)?

  • Could I afford the out-of-pocket maximum if I had to pay it?

3. Are my doctors covered by this plan?

  • How big is the plan’s coverage network? What kind of network is it?

  • Is there a list of doctors/specialists that I can choose in this plan to make appointments that meet my needs (are they in-network)?

  • How much will I pay if I see a doctor who isn’t covered by this plan (out-of-network)?

  • Do I plan to get out-of-network care? Am I willing to switch doctors or locations if the ones I want aren’t in-network?

4. What is this health insurance plan’s prescription drug coverage like?

  • How much will I pay for my regular prescriptions? Are they affordable?

  • Do I need my health plan’s approval for any prescriptions before I fill them?

  • Which pharmacies are in-network? Are their hours and locations convenient?

  • What are my options if my prescriptions aren’t covered?

5. Will this health insurance plan make it easy to get care if I’m sick?

  • Do I have to pick one primary clinic or doctor I always go to first?

  • Are there covered urgent care clinics or emergency rooms nearby?

  • Does the plan include telehealth and free transportation?

6. Will this health insurance plan make it easy to get preventative care if I’m well?

  • Are there free services to keep me healthy? Which ones are important to me and my family?

  • Will I pay anything for regular checkups, annual OB-GYN visits or routine tests?

  • Will I pay anything for regular immunizations, like a flu shot?

7. Will this health insurance plan still be right for me if my needs change?

  • What happens if I move or get a new job?

  • If I decide to have a baby or decide to adopt, how will the child be covered?

  • What if I or someone in my family develops a serious health condition?

  • Am I expecting any big life changes in the next year or so?

8. Is it easy to get support and advice with this plan?

  • Can I call a nurse whenever I have a health question?

  • Who will I call if I have a question about my insurance? When are they available?

  • Are there people available to help me and my family pick the right plan?

  • Will I know how to get in touch with the right people when I need to?

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