Questions To Ask Your Agent
When you’re deciding to buy family insurance for your health care needs, your first step is to educate yourself on the type of insurance plans that are available. People have different priorities about when and how they want to spend their dollars, and the plan that’s just right for one family won’t suit the needs of another. You might start your search by developing questions to ask your agent.
Before you start to put those questions to ask your agent together, read on for background information about insurance. With this information in-hand the next step is to develop the questions to ask your agent.
• PPO plans are the most common kind of family insurance. Your insurance company gives you access to a list of providers and, as long as you visit doctors, labs, hospitals, and other health care professionals that are on the list, you will pay lower rates for your needs. That’s because the insurance company has negotiated lower rates with these providers, usually in exchange for a guaranteed pool of customers and a promise of quick payment.
• POS plans and HMO family insurance plans are very similar, and they are a little cheaper than PPO plans. You must choose ONE doctor-your primary care physician (PCP). You cannot visit any other specialist or even go to the emergency room unless you check with him first. (You should always, of course, go to the emergency department if you believe your illness is life threatening.) The POS plans place more concern on controlling costs by directing who you see. HMO plans do that but also place emphasis on preventive health care measures so that you won’t get sick in the first place.
• Fee-For-Service (FFS) or Indemnity plans are the old-fashioned kind. You have insurance, you go to any doctor, and the insurance company pays. The price tag for this virtual freedom of choice is a bigger chunk out of your wallet. Some FFS plans require you to contribute a co-pay in exchange for a smaller premium.
• High-Deductible High-Premium (HDHP) family insurance plans mean that you pay for everything up front-eventually you will meet your deductible, and everything else is covered. These plans cost less. They work well if you are younger and presumably healthier, because theoretically you won’t spend much money on health care during the year. They are also excellent choices for the seriously ill person who will meet his deductible relatively quickly. These plans go hand-in-hand with HSAs, which are savings accounts with tax advantages and can be used only for health care costs.
Here, then, are some questions to ask your agent. You should ask these questions when you are considering family insurance policies. Make a chart and jot down the answers to these questions for each company that provides quotes to you. Be sure to add your own questions to ask your agent to the list as well.
• How much are the premiums?
• How much is each office visit?
• Do I have to choose a primary care physician or stay in a network?
• What do I pay in network versus out of network?
• Of the prescriptions your family members take, what’s the co-pay on each of them?
• How much is the yearly deductible?
• What’s covered?
• What’s out of pocket?
• Are there limits on the number of x-rays or office visits permitted per year?
• What’s the time limit for pre-existing conditions?
• Will new conditions affect my policy renewal?
• Will the plan put a cap on my out-of-pocket expenditures?
• What happens if I’m traveling and I get sick? What if I’m away for one month, or two?
• What’s the lifetime limit?
Finding the right insurance coverage for your family starts by examining all of the insurance options that are available to you. You can conduct the research alone. A better solution may be to schedule an appointment and bring a well thought out set of questions to ask your agent.
