Questions to Ask Potential Insurance Companies

How much will this insurance plan cost me?
What will this insurance plan cover?

How much will this insurance plan cost me?

There are multiple expenses to health insurance. It is important to ask each of the following questions to each potential insurance company for each plan that you are looking at to be able to estimate the complete cost for each healthcare plan. These questions include, but are not limited to:

  1. How much will my premium be?
  2. Will I have a deductible? If so, how much will it be?
  3. How much will my copays be (for specialists, medications, well visits)?

You will want to consider each plan as a whole; this means weighing the cost of each plan and what that plan covers when deciding on what plan is best for you.

What will this insurance plan cover?

Knowing what insurance plans cover can assist you in choosing the insurance plan that is right for you. Here are examples of things you may want in an insurance plan (but it is not an exhaustive list):

  • Well visits
  • Visits for when sick
  • Specialty doctors (and what the copay will be)
  • Medications
  • Medical supplies (this is general and some insurance companies/plans do not cover every type of medical supply)
  • Durable medical equipment (check on if you can only get one type DME at a time, and if there is a limit per a certain number of years).
  • Emergency room visits, if it is covered or what your copay will be
  • Hospital stays 

You will want to consider each plan as a whole; this means weighing what each plan covers along with the cost when deciding what plan is best for you.

Does this insurance plan have a customer liaison to assist me?

As a customer with a disability or complex medical need, it is beneficial to utilize a liaison if the insurance company provides one. A liaison is a person who gets to know your specific medical needs as well as providing you with their insurance knowledge (e.g. language and policy). 

A liaison will be in your corner helping you work through the process of receiving the medical care you need. This includes but is not limited to purchasing durable medical equipment, medical supplies, or a medical test. A liaison also helps you understand what your medical coverage entails for surgeries, procedures, or many different kinds of office visits.  

Will my current doctor(s), medical supply company, durable medical equipment company, etc. still be in-network under this new insurance?

If you are comfortable with your current doctor(s), medical supply company, durable medical equipment company etc., it is important to know if they are all going to continue to be in-network under your new insurance plan. If they are not in-network, your insurance coverage will not pay for those visits or supplies, and you will be responsible for the bill. 

You do not want to pay for both insurance and the complete cost of the things you need unless you absolutely have to. Find an insurance plan that you can afford and that covers what you currently need.

How many visits will this plan cover?

Whether you are going for a dental cleaning or physical therapy visits, it is important to know how many visits your insurance plan covers every year. The number of visits you can receive per year can also be more complex than just a number. Sometimes physical therapy and massage therapy are part of one total. Your number of visits can also be limited to less than the total number of visits allotted per year if your insurance company determines that your progress is not improving at the rate that the insurance company deems acceptable or you have met your progress goal.

Also, be aware that medical, dental, and vision can all be covered under different plans and/or from different companies which means you will need to pay a premium to each of these companies to receive coverage.