Health Insurance

• Is this insurance? Or is it a discount card, health sharing ministry, or other non-insurance product?
• How long does this plan last? Do I have the right to renew it if I want to? Or can the plan deny me at renewal?
• Who regulates this plan or product? (Is it the state, federal government, no one?) Who would I complain to if I have a problem?

• Does the plan cover existing health conditions, like diabetes and high blood pressure?
• Is emergency care covered?
• Are hospital stays covered? Is there a limit to the number of days?
• What does the plan NOT cover, like pregnancy or mental health?
• Do I get drug coverage with this plan? If so, are brand name drugs covered or only generics? Does it cover the drugs I take?
• Does the plan limit how many times I can see a doctor?
• Is lab work covered?
• Is there a waiting period before I can start using this plan?

• Can I get a Marketplace subsidy to help pay for this plan?
• Is there a limit to how much I may have to pay out-of-pocket for covered medical care?
• How much is the deductible? (That’s the amount you will have to pay before the health plan pays.)
• What are the copays? (These are fixed amounts you will pay for certain services. For example, an emergency room visit may have a $200 copay.)
• Will I pay coinsurance (a percentage of the costs) for certain services?
• Does the plan pay my medical providers? Or does it pay me, and I pay the medical bills?

• Do I have to use doctors, hospitals, and urgent care centers in your network or can I use any that I want?
• Do I have to ask the plan before I can see a specialist?
• Can you check to see if my current doctor is in network with this plan?

Here are some warning signs that you might want to move on to another company. 

• The agent or salesperson cannot answer basic questions about the plan, such as those on our shopping checklist.
• You feel pressured to decide right away. There are no limited time offers in health insurance. No one can promise you a special deal.
• A price that is much lower than other companies you’ve checked with probably means the plan has fewer benefits and more limits.
• You get a call or email from a company or person you didn’t contact first.