15333 Culver Dr. STE 340 -1D Irvine, CA 92604-3051
FAQ's
? Will this health Insurance help me save money if I am healthy?
Imagine that under the plan you are considering, you and your family have good health year. You go to the doctor a few times for check-ups, your partner takes a couple of prescription, the kids visit urgent care a couple of times – and that’s about it. If you don’t expect to use your plan that often, pay close attention to recurring cost to see if there is an opportunity to save money. But remember: it’s impossible to fully plan for the unexpected, so be sure to also factor in the cost of getting care if (and when) you need it.
Related question to asked:
- How much will I pay each month (monthly premium)?
- How much will I pay to see my doctor, visit urgent care, go to the emergency room or fill prescription (co-pays)?
- If I get the same care last year, what would it cost?
- Does the bottom line fit my budget?
? Will this health insurance plan be affordable if I am sick?
Now imagine the opposite scenario, where you use your plan a lot: you come down with an infection and need to stay in the hospital for a few days, your partner’s prescription list grows, the kids break few bones at practice on top of getting strep in the fall- and more. It’s always hard to see a situation like this coming, so it’s wise to be sure that your plan makes care affordable if you need to use it. In the end, you’ll want to aim a good balance between expenses you can plan for (like monthly premium’s deductible’s and the out of pocket maximum) and ones you can’t (like co-pays or coinsurance you pay only when you need care).
Related question to ask:
- How much will I have to pay before the plan starts to help (deductible)?
- What’s my share of the cost of other care, like getting an x-ray or staying in the hospital (coinsurance)?
- What’s the most I’d have to pay for care next year (out of pocket maximum)?
- Could I afford the out of pocket maximum if I had to pay?
? Are my doctors covered by this plan?
Health insurance companies work with different doctors and clinics to help you get the best deals on your care. Getting care froma person or place your plan covers saves you money. On the other hand, getting care somewhere else may mean your health plan pays less, leaving youwith bigger bills. That'swhy you'll want to check that the doctors and clinics you expect to visit will be covered by the health insurance plan you're considering.
Relatedquestionstoask:
- How big is the plan's coverage network? What kind of network is it?
- Is my current doctor covered by this plan (Are they in-network)?
- How much will I pay if I see a doctor who isn't covered by this plan (out-of-network)?
- Do I plan to get out-of-network care? Am I willing to switch doctors or locations if the ones I want aren't in-network?
? What is this health insurance plan's prescription drug coverage like?
According to Georgetown University..Two-thirds of all adults in the United States use prescription drugs, so there's a fair chance you will,too {if you're not already).
It's not unusual for people to get so focused on the medical details of their health insurance plan they forget to look at the prescription drug coverage.These costs can add up,so be sure to review the plan's formulary {druglist). The formulary will tell you which drugs are covered and how much they'll cost.That way, youcan better planyour budget for any current drugs you are taking (andany future ones you might need, like antibiotics).
Relatedquestionstoask:
- How much will I pay for my regular prescriptions? Are they affordable?
- Do I need my health plan's approval for any prescriptions before I fill then?
- Which pharmacies are in-network? Are their hours and locations convenient?
- What are my options if my prescriptions aren't covered?
?Will this health insurance plan make it easy to get care if I'm sick?
Waking up with a sore throat or sinus infection is neve rfun. When it happens, you want to feel better and find care -fast. Waking up with a sore throat or sinus infection is never fun. When it happens, you want to feel better and find care -fast.
Relatedquestions toask:
- Do I have to pick one primary clinic or doctor I always go to first?
- Are there covered urgent care clinics or emergency rooms near by?
- Does the plan cover virtual care options, like virtuwell?
? Will this health insurance plan make it easy to get care if I'm well?
Remember:health care is health care. To make the mostof your plan, you'll want to investigate what kind of benefits it has not only when you're sick but also when you're already well. With a better sense of how your health insurance plan will help you keep feeling your best, you can save a few trips to the doctor's office (and probably a few bucks.too).
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15333 Culver Dr. STE 340 -1D Irvine, CA 92604-3051
