Here are some things to look for when choosing a plan.
1. Do you want to keep your doctor? If yes, then you need to make sure that he is in the plan’s “network”. Each health care plan has their own network of doctors that you can choose from. Each plan should have a list of the doctors on their plan. Check to make sure your doctor is on that list. If you are willing to change doctors, then check to make sure there is a doctor in your area that you would like to go to. Check on their reviews, their office hours, and other things that are important for you. At times, there may not be a doctor within a reasonable distance from your home or work. In that case, check on a different plan. Same applies for your OB/GYN, make sure they are included in this plan.
2. Do you have or believe you will need a specialist? If yes, then make sure that your specialist is also in the plan’s network of doctors. Also make sure you understand what the policy is for using specialists. Some plans require a referral from your primary physician.
3. Hospitals and emergency care. Make sure there are hospitals in your area that are supported by this plan. Also look at the emergency and hospital coverage, including emergency room costs, hospital co-pays, and out of pocket expenses.
4. Physicals and health screenings. Find out what your plan covers. Make sure to understand what preventative care is covered, especially if you have children. Look to see what immunizations and well baby check-ups are covered.
5. Prescription Drug Coverage. If you are taking medication on a regular basis, then pay special attention to this item. Look at the details of drug coverage on your plan, what drugs do they cover and what is the copay. This can vary between plans, so make sure your plan meets your needs.
6. Other Services. Look at the other services that may or may not be included in your plan, ensure that they include the ones that you may need. These services may be mental health care, chiropractic care, home health care, hospice care, rehabilitation, alternative treatments, etc.
7. Cost. Last, but not least is cost. What is the premium (monthly cost), what are the deductibles, which is how much you have to pay out of pocket, before the insurance kicks in? How much will the insurance plan pay, even after the deductible is met. What is the copay when you visit your primary doctor, a specialist, the emergency room, or for a hospital stay? Is there a yearly maximum that you will have to pay?
Feeling Overwhelmed? There are many factors that go into choosing the right plan.
Florida Health Agency can help you navigate through all of these things.
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