health insurance

10 Must-Ask Questions When Choosing Health Insurance

We know that navigating the world of health insurance can be as stressful as trying to find parking on a busy city street. But fear not, because we’ve got your back.To make this process a breeze, we’ve put together a list of ten questions that will guide you in choosing the ideal health insurance plan for you, your family, your well-being, and your wallet. With these questions in your toolkit, you’ll be able to compare health plans like a boss and find the one that checks off all your boxes. Whether you’re a newbie to health insurance or looking to switch things up, these questions are your golden ticket.

1.Will this health insurance plan save me money if I’m healthy?

Picture this: you and your family have a fantastic year of good health. Few doctor visits, minimal prescriptions, and hardly any urgent care trips. If you don’t anticipate frequent healthcare needs, pay close attention to recurring costs that can help you save money. But remember, life is unpredictable, so be prepared for unexpected healthcare expenses too.

Questions to consider:

  • How much is the monthly premium?
  • What are the copays for doctor visits, urgent care, emergency room visits, and prescriptions?
  • If I receive the same care as last year, how much would it cost?
  • Does the plan fit within my budget?

2. Will this health insurance plan be affordable if I’m sick?

Now let’s envision the opposite scenario: you face various health challenges throughout the year. Hospital stays, increased prescription costs, and unforeseen medical emergencies become the norm. Ensure your plan strikes a balance between expenses you can anticipate (monthly premiums, deductibles, and out-of-pocket maximums) and those you can’t predict (copays and coinsurance for necessary care).

Questions to consider:

  • How much do I need to pay before the plan starts covering costs (deductible)?
  • What’s my share of the cost for other care, such as X-rays or hospital stays (coinsurance)?
  • What’s the maximum amount I’d have to pay for care in a year (out-of-pocket maximum)?
  • Can I afford the out-of-pocket maximum if the need arises?

3. Will my doctors be covered by this plan?

Your trusted healthcare providers play a crucial role in your well-being. Check if the health insurance plan you’re considering includes your preferred doctors and clinics within its network. Staying within the network saves you money, while seeking care outside the network may result in higher bills.

Questions to consider:

  • How extensive is the plan’s coverage network?
  • Does the plan cover my current doctor (are they in-network)?
  • How much will I have to pay if I see a doctor who isn’t covered (out-of-network)?
  • Am I willing to switch doctors or locations if my preferred choices aren’t in-network?

4. What is prescription drug coverage like?

Prescription drugs are a common part of healthcare for many individuals. Don’t forget to examine the plan’s formulary, which outlines the covered drugs and their associated costs. This information will help you budget for your current prescriptions and any future medication needs.

Questions to consider:

  • How much will I pay for my regular prescriptions? Are they affordable?
  • Are any prescriptions subject to pre-approval by the health plan?
  • Which pharmacies are in-network, and are their hours and locations convenient?
  • What options are available if my prescriptions aren’t covered?

5. Will it be easy to access care when I’m sick?

When illness strikes, you want quick and accessible care to help you recover. Consider how easily your plan facilitates access to covered care. Equipped with this knowledge, you’ll know exactly where to go and what to do at the first signs of sickness.

Questions to consider:

  • Do I need to choose a primary clinic or doctor as the first point of contact?
  • Are there covered urgent care clinics or nearby emergency rooms?
  • Does the plan offer virtual care options, like Wellthi’s trusted partner, Virtuwell?

6. Will it be easy to access care when I’m well?

Remember, healthcare isn’t just for when you’re sick. Explore the benefits your health insurance plan offers to keep you healthy. By understanding how your plan supports preventive care, you can minimize doctor visits (and save some bucks too!).

Questions to consider:

  • Are there free services to promote overall well-being that are important to me and my family?
  • Will I incur any costs for regular checkups, annual OB-GYN visits, or routine tests?
  • Will I need to pay for immunizations like the flu shot?

7. Does this plan cover alternative therapies?

Interested in alternative therapies like chiropractic care, home births, or acupuncture? Different health plans have varying coverage policies for alternative medicine. If these therapies matter to you, closely examine your plan’s benefits.

Questions to consider:

  • How much do alternative therapies or services cost?
  • Is there any cost-sharing for alternative medicine?
  • Do I plan on frequently utilizing alternative therapies, or am I open to other treatments?

8. Are there additional perks and benefits?

Health insurance plans can offer more than just medical coverage. Look out for extra perks and benefits that can enhance your well-being and save you money. From health coaches to discounts on gym memberships or groceries, you might find some pleasant surprises.

Questions to consider:

  • Does this plan provide unique benefits that others don’t?
  • Will I actually use these additional perks? Which ones align with my priorities?

9. Will this health insurance plan adapt to my changing needs?

Life is unpredictable, and your health needs may evolve. Ensure that your chosen plan can accommodate changes along the way. By understanding how different life events impact your coverage, you can make a confident decision from the start.

Questions to consider:

  • What happens if I move or change jobs?
  • How will a new addition to my family be covered (e.g., having a baby or adopting)?
  • What if I or a family member develops a serious health condition?
  • Are any significant life changes expected in the next year?

10. Can I easily seek support and advice with this plan?

Healthcare can be complex, and questions may arise regarding insurance or care. Find a plan that prioritizes member support and offers easy access to guidance. Whether it’s a 24/7 nurse line or a dedicated support team, knowing you have reliable assistance when needed is invaluable.

Questions to consider:

  • Can I contact a 24/7 nurse line whenever I have health-related queries?
  • How can I reach someone to discuss insurance questions, and when are they available?
  • Are there knowledgeable individuals who can help me select the right plan for me and my family?
  • Will I have the necessary contact information when I need it?

Getting answers to your health insurance questions

Remember, health insurance plans aren’t one-size-fits-all. It’s essential to speak with someone who can help match your unique needs with the perfect plan. At Wellthi, we’re here to guide you every step of the way on your journey towards financial well-being. Together, let’s achieve your goals and secure a healthier future.


How To Choose A Health Insurance Plan For Your Family- Forbes

What to look for in a health insurance plan– March of dimes

Types of Health Insurance– Investopedia