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Insurance
Questions to Ask
By the Ohio Department of Insurance
Ask questions to identify a health care plan that provides needed benefits but is also affordable. Make a list of your needs to compare them with the benefits offered by plans you are considering. Compare plans and try to find out why one is less expensive than another. Here are some good questions to ask when you're shopping.
- What does the health plan pay for and not pay for?
- Will the plan pay for preventive care, immunizations, well-baby care, substance abuse, organ transplants, vision care, dental care, infertility treatment, durable medical equipment, or chiropractic care?
- Will the plan pay for the prescriptions I take? What other prescriptions will it pay for?
- Does the plan have mental health benefits? Will the plan pay for long-term physical therapy?
- Do rates increase as I get older?
- How often can rates be changed?
- How much are deductibles and copays?
- How much is the out-of-pocket maximum?
- Are there any limits (annual or lifetime benefit caps) on the number of times I am covered for a service?
- Are there any restrictions on the use of providers or services under the plan?
- Does the health plan require me to see providers in a network?
- Does the plan pay for me to see providers outside the network?
- Are network providers conveniently located?
- Is the doctor I want to see in the network and accepting new patients?
- Does my doctor have admitting privileges to the hospital of my choice?
- Which urgent care centers does the plan contract with?
- What do I have to do to see a specialist?
- How easy is it to get an appointment?
- Has the company had an unusually high number of consumer complaints?
- What happens when you call the company's consumer complaint number?
- How long does it take to reach a real person?
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