Hints on Shopping for Health Insurance

Helpful questions to consider as you shop for health insurance.

Charge a premium in addition to the Medicare Part B premium?
Charge copayments for doctor visits?
Pay for prescriptions? How much?
Limit the drugs it pays for to those on a specific list of drugs (called a formulary)?
Cover the drugs I use?
Charge more if I use a doctor or hospital outside the plan? How much?
Have maximum amounts it will pay for different services?
Set limits on what doctors and hospitals charge you?
Charge a deductible or coinsurance for inpatient hospital services, home health, or skilled nursing facility services?
Cover routine physicals?
Cover eye exams, glasses, contacts?
Cover dental exams/treatments?
Cover programs that focus on helping members with specific, chronic conditions such as asthma, diabetes, or heart conditions?

May I use my regular pharmacy?
Are mail-order pharmacies available?
What is the annual or quarterly dollar limit on prescription drug coverage?
Will I have to pay more if I prefer to use brand name instead of generic drugs?
Is there a maximum out-of-packet cost for prescription drugs? What is it?
Are the hours and location of its doctors, clinics and other health care providers convenient?
Is my access to emergency care convenient?
Are the doctors' offices, lab, and other services convenient?
How fast can I be seen for urgent (non-emergency) care?
Is there a telephone hotline for medical advice?
Are my doctors in the plan?
Is there a selection of the doctors, health professionals, and hospitals that I might need?
Can I get the doctor I want? Is he/she accepting new patients under that plan?