Five Questions to Ask when Shopping for Health Insurance

November 08, 2017 / Nancy Ridge

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Shopping for health insurance is a daunting task, and with the Affordable Care Act in place, consumers have more options to choose from than ever before. Did you know that in some markets there are as many as 50 choices?

Finding the right health plan for your needs doesn’t have to be confusing. Start by answering these five questions to help guide your search for the perfect plan!


1. Are you looking for health insurance for the first time or do you have a health plan you could renew?

If you are looking for health insurance for the first time, you need to decide what is most important to you. Is it low monthly costs, generous coverage with low co-pays, or the ability to see specialists without a referral? Set your priorities before you shop to help make your search more streamlined.

If you were part of a plan in 2017, you’ll need to decide whether to keep your plan or elect a new one, based whether the plan details have changed and whether your old plan still suits your needs.


2. How much coverage do you need?

The answer here is based on your general health, and that of those who depend on you. How often did you or your family members visit the doctor last year? The answer to that question is a good indicator of what to expect in the next year unless something has changed. No one can predict the future, but if you have been generally healthy, there’s no reason to expect that will change suddenly, and you can probably choose a plan with low premiums and less coverage.


3. What kind of plan do you want?

Consumers have several choices when shopping for health insurance, but there are three major types of plans. HMOs are also called “managed care” – this option will usually offer a small group of doctors to choose from, and your primary care doctor will act as your first point of entry for all health services, referring you to other doctors as needed. A PPO, on the other hand—preferred provider organization—usually offers a network of providers who you may see without a referral from your primary care provider. The PPO option generally carries higher premiums and is more expensive overall.


4. How will your plan handle emergency care?

This is a key question for anyone electing new insurance. Though no one can plan for an emergency, you want to be sure you’re covered if you or someone in your family needs immediate care. Before you choose a health plan, check to make sure your choice includes emergency visits, ambulance rides, hospital stays and procedures such as X-rays and MRIs.


5. Do you have, or are you planning to have, children this year?

Young children tend to get sick more often than healthy adults, simply because their immune systems aren’t fully developed and they are exposed to lots of germs at school. Make sure your plan covers both sick and well-child visits and the cost of needed vaccinations.

If you are considering expanding your family, you will want to consider a few other things when shopping for your health plan. Check to make sure that pre and post-natal care are offered and included in your coverage, and ensure that once your new family member arrives, your plan will cover his or her needs as well. Even healthy babies spend a lot of time visiting the doctor during their first years!

Shopping for health insurance can be a daunting task, whether you’re looking at the marketplace or selecting from employer offerings. Keeping these five questions in mind when you shop will keep you on the right path toward finding the perfect plan for you and your family! ​

Category: Health Insurance