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10 Key Considerations When Comparing Health Care Plans


Having to choose between multiple health care plans can be a daunting task. Here are 10 key areas to consider when you need to find the best health care plan for your needs:

1. Your Doctor: Some health care plans require you to use their network of doctors. If you currently have a physician that you would like to keep seeing, then check first to see if your doctor is included in the health care plan you are considering. If you need to choose a new doctor from the health care plan consider researching the doctors credentials by calling the medical office she works for or checking with the AMA. Location and availability are other factors to consider when choosing a doctor. Not only check where the doctor is located but you will also want to find out the hours of the facility and see if the doctor is available all of those hours as some doctors work in multiple facilities.

2. Specialists: If you have specific medical conditions or believe you may need to use specialists in the future you will want to find out how you will be able to use a specialist. Check to see if you will always need to contact your primary care physician first. You will also want to find out if a current specialist you use is an in-network doctor for the health care plan you are choosing.

3. Pre-Existing Conditions: This seems like a no-brainer but sometimes in the confusion of choosing health care plans many forget to confirm that their pre-existing condition will be covered or one just assumes it is. Pre-existing conditions can vary between plans from being excluded to being covered fully and sometimes somewhere in-between like being covered after a specific amount of time. The Health Insurance Portability and Accountability Act ensures coverage for pre-existing conditions if you are joining a new group plan from your employer and you were insured the previous twelve months.

4. Emergency and Hospital Care: You will want to find out what emergency rooms and hospitals are covered on your plan. In addition, find out what constitutes an “emergency.” Sometimes your definition of an emergency may not be the same as the health care plan you are considering and it could possibly not be covered. Also, check to see if you need to contact your primary care physician first before getting emergency care.
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