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Insurance plans vary. Before choosing a plan, decide what is most important to you. This checklist can help. Put a check in front of those services that are important to you. Then see how many of these services are in Policy #1, Policy #2, and Policy #3.

Decide what services are most important to you, the cost of your policy could vary based on the services it offers. Many policies these days have "up to" amounts for coverage for things like outpatient surgety, physical therapy, etc.. Often times this can keep you policy cost down in choosing one that has has a lower "up to" amount

Ask The Following General Questions: Plan A Plan B Plan C
Can I choose a primary care provider (PCP) or will I be assigned to one?      
Are there a variety of PCPs to choose from in the plan?      
Can I self-refer to a specialist, or must my PCP refer me?      
Is pre-authorization required before going to the hospital or for tests or procedures?      
Do I have to file my own claims?      
How soon will coverage begin after the plan goes into effect?      
If applicable, will the plan treat my pre-existing condition?      
Will the plan cover me if I am traveling?      
Will the plan provide coverage for critical or long-term illness such as cancer?      
Can I choose a hospital or will one be assigned?      
Does the plan work in conjunction with a health savings account?      
Check All Included Covered Services: Plan A Plan B Plan C
Office visits      
Physical exams, health screenings and preventive care      
Prenatal and maternity care      
Immunizations      
Cancer screening tests (mammograms, pap smears, colorectal and prostate cancer tests)      
Cholesterol screening      
Laboratory tests and X-rays      
CAT scans, MRIs and other diagnostic tests      
Prescription medications      
Vision care, eye exams and eyeglasses or contacts      
Dental exams, braces and cleaning      
Mental health services and counseling      
Hearing exams and hearing aids      
Home health care      
Rehabilitation facility care      
Home medical equipment      
Physical therapy      
Speech therapy      
Adult day care      
Nursing home care      
Hospice care      
Drug and alcohol abuse treatment      
Alternative treatments (acupuncture, chiropractic, etc.)      
Experimental treatments      
Outpatient surgery      
Check All Included Covered Hospital Services: Plan A Plan B Plan C
Emergency care      
Ambulance services      
Physician visits      
Transplant surgery      

Check Out The Company

Before purchasing any plan, make sure the company has a strong financial rating. Standard & Poor’s, Weiss Ratings, A.M. Best and Moody’s are independent agencies which evaluate the financial strength of health insurance companies.

You should also read the plan’s coverage contract, which may be called a “certificate of coverage” or “evidence of coverage.” It explains which services are covered and which are excluded in more detail than the summary of benefits.

No matter which health insurance plan you choose, you want to be sure you will receive quality care. To learn more about health care research and quality visit the Agency for Healthcare Research and Quality at www.ahrq.gov or the National Committee for Quality Assurance at www.ncqa.org.

Is the managed care organization accredited? Many managed care organizations choose to become accredited by one of several independent agencies. Accreditation provides a “seal of approval” and assurance that the organization meets a set of standards.

To find information on your state, call the National Association of Insurance Commissioners at (816) 842-3600 or visit www.naic.org

Before choosing any health plan, make sure that it is convenient for you and your family.

  • Where are the physicians’ offices located?
  • How easy is it to get an appointment and how quickly can you get an appointment?
  • Does the physician reserve some time each day for emergencies or walk-in patients?
  • Are the hospitals or other facilities convenient and easily accessible?
  • Do you have the option of going to an outpatient facility for certain tests or treatments?

Just because plans offered by different insurance companies provide standard benefits, do not assume that they cost the same. Compare all the costs, including deductibles, co-payments and the benefits provided.

Use the above work sheet and the Comparing Health Insurance Plans Costs work sheet to compare health insurance plans and to identify your out-of-pocket costs for the plan you are considering.




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