Most people look at costs, deductibles, copays, monthly premiums and the out-of-pocket maximum while shopping for a good health insurance plan with adequate coverage. This is often the blueprint for scouring the Affordable Care Act marketplace for a plan that suits you. However, in the rush to get the best deal possible, you may miss a few key details. Here are five crucial factors to consider.
What Do You Do If Your Doctor Isn’t ‘In Network’
Most health care plans have a network of medical care professionals that you are required to visit for all your health care needs. It is important to check whether your doctor is in the network. If he isn’t, and it is important to you that he continues to be your care provider, ask him what networks he is a part of so that you can review those plans. If the plan you’re considering is too good to pass up, find a new doctor from the list provided by your insurers. Look up her/his credentials, ask for patient reviews and find out her/his daily visiting hours. You also need to see that the location of the practice is convenient to get to.
How Long Are The Waiting Periods
Some plans have waiting periods where you can’t access care for a stipulated time to ensure you don’t have pre-existing conditions. Be careful to find out how long these are and review how it could impact your health care.
How Does The Policy Define ‘Emergency’
In addition to reviewing the list of emergency rooms and hospitals covered in your plan, you need to hammer out the details of what constitutes an emergency in the policy you are considering. It is better to have no doubts about what will and will not be covered before you sign the dotted line.
How Do Fertility Treatments, Pregnancy And Childbirth Figure In The Policy
Even if you are not pregnant now, you should find out whether your regular obstetrician or gynecologist is covered. If you are considering fertility treatments, seek out the out-of-pocket costs you will have to bear and find out the coverage details for the length of your pregnancy right up to childbirth and postpartum visits.
Does The Policy Cover Any Additional Services
These services could include drug and alcohol rehabilitation, mental health care, hospice, counseling or therapy, chiropractic care or experimental treatments.