Health insurance policies are detailed documents, and there are multiple items to check when you compare policies and ultimately choose one. As you work with an insurance agent to find the best health insurance policy for yourself, here are three important questions to ask.
1. What Providers Are in the Policy’s Network?
Health insurance policies come with networks of providers, which include both medical practitioners (e.g., doctors’ offices) and medical facilities (e.g., hospitals and clinics) that accept the insurance. Treatments from in-network providers are covered at higher rates than those given by out-of-network providers.
Because of the discrepancy in how a policy covers costs from in-network and out-of-network providers, you’ll pay substantially less if you see an in-network provider. This applies to anytime you need medical treatment, but there are three situations where you especially want to make sure your provider is part of your health insurance policy’s network.
First, whatever health insurance policy you choose should include your primary care physician in the policy’s network. Your primary care physician is your initial point of contact for most common illnesses and injuries, and you could visit them several times a year if you get sick repeatedly. If they’re outside a policy’s network, costs for these visits could add up.
Second, you should check what hospitals and emergency clinics in your area are part of your new policy’s network. You might even want to make a list of them for quick reference in the event of an emergency. Hospital visits and emergency treatments can be particularly expensive, so you’ll want to see an in-network facility for these if possible.
Third, you should also try to find a policy that includes any specialist you see regularly within the policy’s network. If you have a chronic condition that requires care from a specialist, those repeated visits to the doctor’s office will be more affordable if the specialist is in your policy’s network.
2. What Prescriptions Are on the Policy’s Preferred Drug List?
Health insurance policies also come with a list of preferred drugs. This list acts akin to how a provider network does, except the list is for prescription medications rather than doctors, hospitals, and clinics. Drugs that are on a policy’s preferred drug list are covered better than non-preferred drugs and therefore, cost you less if you need one of the medications.
If you take any brand-name prescription medications regularly, look for a policy that includes those medications on its preferred drug list. This will ensure you can get your necessary medications at an affordable price thanks to the policy’s coverage.
Even if you don’t currently take a regular prescription medication, you should still ask for a copy of your policy’s preferred drug list and keep it on hand.
If you need a new prescription drug during the year, you can show this list to your doctor and ask them if any of the medications on the list would be suitable for you. If multiple medications would work in a given situation, your doctor can choose one that’s on the list to help you save a little on your out-of-pocket pharmacy costs.
3. How Much Are the Premiums?
Of course, you’ll want to know what the premiums for a policy are before you purchase it. Premiums are the monthly amount that you must pay to maintain an insurance policy, and you’ll at least need to know the amount for your own budgeting purposes.
If you’re self-employed, however, there’s another reason to find out what your policy’s premiums will be. Health insurance premiums for self-employed individuals are tax-deductible, and you can ask a certified public accountant exactly how deducting the premiums will impact your tax situation once you know what the premiums are.
If you need help finding a health insurance policy, contact Callis Insurance.