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Top 11 Questions To Ask When Choosing A Healthcare Plan

image of healthcare worker explaining healthcare plan options to elderly woman

There are several important questions to ask when choosing a healthcare plan. If you are new to the selection and application process, you may find it challenging. As a result, you might be stressed out and feel discouraged from moving forward. 

That’s why My Healthcare Direct, professionals in healthcare, has provided you with what questions to ask before deciding on a plan. 

image of doctor taking care of little girl with a healthcare plan

Why You Should Ask Questions Before Choosing A Healthcare Plan

Making inquiries is vital to selecting the best policy. Otherwise, you may be making a decision based on incomplete information. As a result, you may be dissatisfied. More so, you may be stuck with deductibles or premiums you weren’t prepared for.

Performing Research Policies

Recent studies demonstrate that many healthcare consumers lack access to the basic information they need to help them understand how to shop for a plan. Consequently, there are differences between expected coverage and the actual benefits received. 

If you want to avoid making the wrong decision, it is beneficial to research plans before submitting an application. This will enable you to consider your budget restrictions, find policies adequately that meet your healthcare needs, and consider what the insurance excludes. 

The Best Questions To Ask When Choosing A Healthcare Plan

To help you be better equipped, the following are the most pertinent questions to ask when choosing a healthcare plan

1. What Type Of Policy is it?

Before finalizing your choice, you must ask about the type of plan. This allows you to determine whether it meets the criteria you’re looking for.

2. What are My Monthly Premiums, Deductibles, or Copays?

Many insurances have deductibles (expenses paid prior to coverage onset), premiums (monthly costs), or copays (set amount paid per doctor visit). So, if you have spending restrictions, you need a policy that fits within your budget. 

3. Are there any Disqualifying Factors or Conditions?

With certain forms of coverage, you may be disqualified based on age (i.e., Medicare is only for adults 65 and older). Although health insurance companies can no longer deny coverage due to pre-existing medical conditions, this remains a question you should ask. Some insurances, like Medicare, only provide seniors with eligibility. 

4. How Long is the Coverage Period?

Some insurances, such as short-term or long-term (tri-term) insurance, have different coverage periods. Tri-term insurance lasts for up to three years. So, learning the answer to this question is necessary for making your final decision. 

5. What Benefits are Included?

Knowing what benefits are included (i.e., prescriptions, vision, and dental) is essential for narrowing down which options are most appropriate for you. Since these benefits differ in each state, they will be a defining factor. 

6. Can I Use My Own Doctors?

To determine whether your current doctors are compatible with the new policy, you should ask the provider. If you cannot use your own specialists, this may be non-negotiable for you. 

7. Can I Select In Or Out of Network Specialists?

Certain policies don’t allow you to use any physicians that are outside of your approved network. Before enrolling in new insurance, you must be certain about the guidelines for in-network vs. out-of-network specialists.

8. What are the Plan Restrictions?

Certain policies in the marketplace have restrictions. For instance, some may not cover dental or vision, while others do. For what’s excluded, you may need to purchase supplemental insurance. 

Specifically, Medicare has supplements to allow policyholders to purchase additional benefits. Regardless, it’s important to know what’s not provided in the plan, especially if that’s something you need.

9. What is Prescription Drug Coverage?

Each policy has variations in prescription drug coverage. If you have medical conditions that require pharmaceutical treatments, this is a key question to ask.

10. Does the Plan Offer Financial Assistance?

Some insurances, like Medicaid, offer benefits given your income. Those with a lower income quality for more extensive coverage. Knowing what is available enables you to select the ideal plan. 

11. What are the Healthcare Categories?

Marketplace plans have 4 main categories 

  • Bronze
  • Silver
  • Platinum
  • Gold 

They have nothing to do with the quality of care received, but they do vary based on the cost you split with the insurance. Therefore, knowing what category helps you allocate your finances. 

Rely On My Healthcare Direct Experts For Guidance

You no longer have to wonder what questions to ask when selecting a healthcare plan. Our experienced professionals at My Healthcare Direct can assist you with any additional details you ought to consider. As independent insurance agents, we specialize in guiding you toward your healthcare goals. 

Feel free to contact us today to speak with a customer service agent!