1998 New Jersey Managed Health Care Plans
Choosing the Right Health Plan
Choosing the best health plan for you and your family can be a
difficult decision. Before you select a health plan, you may want to think about the following questions:
- Which health plans does your employer offer?
NOTE: Additional information about health coverage options, including Buyer's Guides
for individual and small employer coverage, is available on the Department of
Banking and Insurance web site at
the option "Health Insurance Reform."
- Which health plans offer conveniently located facilities and doctors?
- Which health plans offer the benefits you want?
- How do you obtain services when you are away from home?
- What are the premiums and co-payments for the plans?
- Which health plans include your preferred doctors and hospital?
- Which health plans in this booklet scored well in the areas of quality that are most important to you?
Use the worksheet below to answer these questions by considering information in this booklet and other materials from your employer and the health plans.
List the plans of
interest to you.
Review plan cost
Review plan provider
Review information from each section of this booklet.
|Access & Service
See pages 4-6
See pages 7-8
See pages 9-12
Living with Illness
See pages 13-15
||Care for Kids
See pages 16-18|
Knowing Your Responsibilities
Knowing how your health plan operates can help to increase your
satisfaction. To get the most from your health plan you should:
- Read the member handbook or consult your employer to understand what services the plan will pay for ("covered services") and what it doesn't pay for ("exclusions").
- Ask questions if you don't understand information the plan or provider sends to you.
- Know how to choose or change your primary care physician.
- Know what you need to do to get a referral to see a specialist if your plan requires it.
- Know what your plan requires you to do if you need to use a hospital emergency room.
- Take good care of your health by getting appointments for check-ups or other preventive care.