Health Insurance

25 Shopping for Individual Insurance Shopping for health insurance can seem overwhelming. Think about what is important to you. Start by asking these questions: What are the costs? • How much are the monthly premiums? • Is there a deductible? • How much are the co-pays and/or co-insurance? • What is the plan’s out-of-pocket maximum (the most you would have to pay in one year)? Which doctors and other providers can I see? • Is there a network? How large is it? • Can I see any provider in the network? • Is my current doctor in the network? • If I need to choose a new doctor, are there doctors in my area accepting new patients? • Will I need a referral from my doctor to see a specialist? • Does the plan have hospitals and pharmacies near me? • Do I need pre-approval (pre-authorization) from the plan for certain services? • If I travel often, what kind of care can I get away from home? What are the covered benefits? • What services does the plan pay for? What is not covered? Are the services that I need covered? • How much will I need to pay for my prescriptions? • Are there any limits on the number of visits for some kinds of care?