Choosing Your Health Plan
Your choice of a health plan can influence your health.
Health plan quality, along with choice of providers, benefits offered and costs, can help you decide on a health plan best suited to your needs.
Quality of Care and Service
- Look to see how well the plan performs in each section of this report.
- Pay special attention to the health issues that are most important to you and your family.
- Focus on large differences when you compare plans.
Choice of Providers
- Make sure that your preferred doctor, hospital and other providers participate in the plan by looking in the plan's directory. You can also call the plan's member services department or the provider directly.
- Decide whether the plan has enough of the kinds of doctors you are likely to need and whether they are located near your home or work.
- Find out what types of benefits the plan offers by reviewing the member handbook or calling the member services department.
- Consider your special needs and circumstances such as chronic health conditions, elder care needs, frequent travel, language, retirement and starting a family.
- Decide whether there is a good match between the benefits offered by the plan and what you think you may need.
- Find out what types of care or benefits the plan does not offer.
- Try to get an idea of how much you are likely to pay in premiums, copayments, coinsurance and deductibles each year.
- Find out if the plan covers services by providers outside the network and how much it will cost you for these services.
- See if there are any limits on how much you are responsible for paying in case of major illness (out-of-pocket maximum).
- Find out if the plan places limits on the amount of benefits it will pay (annual or lifetime maximum).