Understand what your plan considers an emergency
Due to the multiplicity of health care plans, it may prove to be very difficult for one to choose the adequate one for one’s needs. Here are a few tips to help you.
• Consider the method of choosing a primary health care provider. In some plans, you are required to choose your doctor from a pool of doctors in the network. If you already have a family doctor, check to find out whether he/she belongs to the network. If not, would you want to change your doctor? If you decide to change your doctor, ensure that you research the credentials and track records of all the doctors in the network, their location and availability. This would inform your decision to buy the policy or not.
• What is the term of agreement concerning pre-existing conditions? If you have a prior health conditions some policies may exclude it or cover it partially or fully. You need to understand this part very well and not take anything for granted. The Health Insurance and Portability Act makes sure that you get coverage for pre-existing conditions if you are changing to a new group plan from your employer or you have been insured for the past twelve months.
• If you have a condition that requires specialist attention or think you might in future, then you need to find out how you’ll get it in the plan you are thinking of buying. Would you be required to consult your primary health care provider first? Or would you need to see only a specialist in the network? You should also find out whether any of the specialists you are currently using belong to the network of the plan you want to join.
• Hospital and Emergency Care. Understand what your plan considers an emergency. Know which hospital and emergency rooms are in the network of the plan you want to join. Also confirm whether you need to consult your primary health care provider before going to an emergency room.