What plan details should I compare?
Compare premiums alongside deductibles, copays, coinsurance and the out-of-pocket maximum for covered care. Review the plan’s benefits, exclusions, network, prescription list and referral rules rather than choosing on premium alone.
How can I confirm whether a provider or service is included?
Check the specific plan’s current provider directory and benefit documents, then confirm network participation with the plan and provider before receiving care. A provider may participate in some plans from an insurer but not others.
What is the difference between a deductible and a copay?
A deductible is the amount you pay for applicable covered services before the plan begins paying its share. A copay is a fixed amount for a covered service. Some services may be covered before the deductible; the plan explains its rules.
What is an out-of-pocket maximum?
It is the plan’s limit on certain costs you pay for covered services during the plan year. Premiums and costs the plan does not cover generally do not count. Check the plan for network rules and what counts toward the limit.
When can I enroll?
Enrollment depends on the type of plan and the applicable enrollment period. Some life events may qualify a person for a special enrollment period. Ask about your situation and deadlines before making a change.