7 Health Insurance Questions You Need to Ask Potential Providers

Nearly 30 million Americans under the age of 65 years old are currently living without health insurance.

With the rising costs of healthcare and the increasing popularity of the “gig economy,” it’s not difficult to see why.

However, the reality is that you simply can’t afford to be uninsured. It’s a huge part of staying healthy and productive in life and the workplace.

Whether you’re ready to choose from a list of potential insurance companies and plans in the workplace or are choosing a healthcare plan that you’ll pay for yourself, you need to know what to look for.

That’s what this post is here to help with.

In it, we’ll tell you the most important health insurance questions that you absolutely must ask potential providers before you settle on a company or specific policy.

Keep on reading to make sure that you pick the option that will best protect and provide for yourself and any family members you wish to cover.

Health Insurance Questions You Need to Ask

  1. What Will I Be Paying?

Of course, first on our list of the most crucial health insurance questions to ask potential providers is all about the cost.

You need to understand how much you’ll be expected to pay when it comes to your monthly premium. You also need to understand the amount of your deductible, or how much you’ll have to spend before your coverage kicks in.

Get a rough estimate of the copays associated with trips to the urgent care center, emergency room, and the doctors and specialists you’re interested in seeing.

You also need to understand the potential cost of your coinsurance when choosing a healthcare plan.

This is what you’ll need to pay after you’ve met the deductible, and how much your insurance company will cover. Usually, this is a percentage, not a set cost.

Additionally, make sure that you understand what your out-of-pocket maximum is likely to be.

Keep in mind that your monthly premium payments don’t count towards meeting your out-of-pocket maximum.

Always take cost into consideration before anything else when you’re in the market for a new health insurance plan.

  1. Can I Keep My Doctor?

Another one of the most essential questions to ask when looking for health insurance?

Whether or not the doctors and medical professionals you’ve worked with in the past will be covered by the policy and network that you’re considering switching to.

Keep in mind that if your doctor is out of network, you’ll be expected to pay those costs out of pocket. Often times, this can be an enormous amount of money.

Weigh the costs of keeping your current doctor or look for a plan that has your medical experts in-network.

  1. What About My Medications?

When you’re choosing a healthcare plan, you need to be sure you understand which of the medications that you’re taking are covered by your plan.

You can also get a rough estimate of how much you’ll have to pay out of pocket to cover the cost of your medication.

You should talk to a potential provider about which pharmacies are available to you. Keep in mind that if you have an HSA insurance plan, you’ll likely need to pay more for your medication up front.

If you don’t currently take any medications, then this may not be an issue.

If you take medications, then you’ll also need to look at how the insurance provider deals with pre-existing conditions. Whether you or someone in your family has a chronic health condition, you need to be sure that the plan will cover costs over the course of several months of treatment.

The plan may also have a limit on how long they’ll provide coverage for these pre-existing conditions.

Always make sure that you take both your medications and pre-existing conditions into consideration when formulating your list of health insurance questions.

  1. Is the Provider Stable?

Many people are so concerned about the cost and coverage associated with a potential provider, they often forget one of the biggest questions to ask when looking for health insurance.

You need to know that the company is financially stable enough to provide for you and your family members in the event of a financial downturn or another problem.

Remember that if the premiums are too good to be true, something is probably up.

You don’t want to find yourself in a situation where you can only see a doctor during work hours, or that you only have access to limited kinds of doctors.

Understand how long they’ve been in business, how many people they provide coverage for, and how they’ll guarantee your coverage.

  1. When Will My Coverage Start?

When you’re in the market for a new plan, you’ll also need to understand when exactly that coverage will kick in.

This can be tricky if you’re getting the insurance through your new employer. This is because these employers usually have a mandatory waiting period before you become eligible to be covered by your company.

If at all possible, wait to see a doctor until you know that you’re completely insured. However, if that’s just not a possibility, look for a plan that gives you immediate coverage.

Be upfront with your employer and the insurance company about your needs.

You’ll also need to be aware of any deadlines for signing up associated with the healthcare plan that you’re considering. Set up reminders on your smartphone to ensure that you don’t miss the signup date.

This is especially essential if you’re under current financial strain. Remember that you’ll likely be forced to pay a penalty fee for being uninsured.

So, always know when you need to sign up by in addition to when your coverage actually begins!

  1. What Benefits Can I Expect?

In addition to understanding the type of plan you get and how much you’ll be expected to pay for it, you also need to evaluate the benefits associated with a health insurance plan.

For example, you might be able to make appointments or chat with a doctor on your tablet or smartphone. You might also be able to work with a nutritionist, health coach, or even a personal trainer to help you get on the right track.

You also need to ask about the costs and coverage associated with mental health care. Keep in mind that many employers will offer a certain number of therapy and counseling sessions to their team members under a certain plan.

If this is something you need, or just feel that you could benefit from, then be sure to bring it up!

Also, ask how the benefits that this insurance company is going to offer are different from the offerings of their competitors. Ask how often they add new benefits, and which ones they are looking to bring on in the future.

  1. What If My Circumstances Change?

Also, remember that sometimes, no matter how stable you think you are right now, things with your health — or your job — can change on a dime.

You might receive a sudden diagnosis. You might lose your job. You might even decide that you want to get pregnant!

The medical insurance questions that you choose to ask a potential provider need to include explanations about how your coverage can provide for these changes.

Understand what happens if you get another job, if there’s a change in your marital status, or if you or someone in your family gets sick.

You may even move to a different country and wonder how your insurance plan will change and what coverage you can get. Click here for more information about how Canadian health insurance differs from that in the United States.

When it comes to your health insurance, it’s always best to be prepared for whatever the future might hold — good news or bad.

Get All Your Health Insurance Questions Answered

When you’re in the market for a new insurance provider, it’s essential that you get as much information as possible before you make your choice.

We hope that this list of some of the most important health insurance questions has been helpful.

No matter what medications you’re on, the level of coverage that you need, or any sort of illness that you have, you deserve the best coverage.

Interested in learning more about what to look out for when choosing a healthcare plan?

We’ve got you covered.

Be sure that you keep on checking back with our blog for all the latest advice about how to choose an insurance plan that’s a perfect fit for your lifestyle and needs.

For more healthy living advice, rely on us to give you the tips you need to thrive.

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