3) Choices are important. Usually, the higher the number of facilities and doctors you can visit, the better. But if you have a favorite doctor and hospital that are within your plan, then a small network may be just right for you.
4) Make sure your doctor is in. Call the office and make sure that your doctor accepts the insurance plans that you are targeting. This will help you make a final decision on whether a plan is right for you.
5) Check the references. No one wants to deal with a nightmare of phone trees and rude customer service if they have to make a claim. Is it important that you are able to reach your insurer 24/7? Do you want to avoid paper billing and just be able to access your account online? Are there negative reviews about how customers were treated (keeping in mind that happy people rarely go online to rave about service)? All of these are considerations when you’re choosing an insurance provider.
6) Make sure the essentials are there. A plan is mandated to cover certain benefits, deemed “essential health benefits,” by most state laws. These include emergency services, hospitalization, lab tests, mental health and substance-abuse services, maternity care, outpatient services, pediatric care, prescription drugs, immunizations and other preventive care, and rehabilitation services. If one or more is particularly valuable to you or may be in the future (like maternity benefits) make sure you know how deep the services run. Some individual plans that were purchased before the Affordable Care Act kicked in may not cover everything.
7) Premiums are tiered. Plans are typically sold based on precious metals. Bronze-level plans have the lower premiums but high out-of-pocket costs, while platinum plans likely will cover 90 percent and have high premiums/low out-of-pocket.