How to Choose Between More than One Private Insurance Option

  • You should find out:
    • Your premium payments for each option.
    • Your co-payments for each option, in network and out of network.
  • Study and compare the benefits for each option.
    • Make sure to ask what your deductible is.
  • Calculate your out of pocket maximum expenses for each option, in network and out of network.
  • Look at the insurance benefits and coverage to determine how well each insurance option will cover your usual medical expenses.
    • Do you have an average of five doctor visits each year?
      • Check into whether each option would cover all five visits or if there is a limit on the number of appointments per year.
    • Do you have periodic diagnostic tests (like a renal ultrasound)?
      • Check into what coverage is provided for diagnostic and monitoring tests.
    • Do you require the use of durable medical equipment (like a pump) or disposable supplies (like insulin syringes)?
      • Check into what coverage is provided for these items.
    • Do you require monthly prescriptions?
      • Check into which option provides the best coverage and co-pays.
      • Also, is there a mail order option? Generally, with mail order, you will pay two co-pays for a three month prescription.
  • Think through your expected medical expenses for the upcoming year and estimate your out-of-pocket costs for these expenses for each insurance option.
  • Consider the convenience of each option and your current providers are in network with each option.

Based on the above, choose which option is best for you. Call your human resources office or a financial counselor if you need advice or additional information. 

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