How to choose a health plan

Health plan home | Health-care models | Choosing a health plan | Choosing a doctor | Helpful hints

HELPFUL HINTS

Do not assume anything about your coverage. Each plan has its own benefits and its own exclusions, limitations, and reductions. For instance, if your current plan covers chiropractors under its preventative care package, do not assume that another plan will cover chiropractic care as well. Find out the specifics, not just the generalities of the coverage.

If you want to continue an existing relationship with a certain physician, specialist and/or facility, make sure that they are affiliated with the plan you are considering.

It is important to remember that your relationship with your current doctor may change if you choose a different model. For instance, if you switch from a PPO to an HMO, there may be significant differences in the way you access care, if you continue with the same doctor. Talk to your doctor in advance if you are considering such a change.

Find out if the healthcare plan has a quality assurance department. These departments are designed to monitor customer service and they may be able to answer many of these questions.

Ask your health plan if you can change doctors later on if you do not like the one you've selected. Or if you find a doctor you like who is not available through your current health plan, you may even decide to change health plans.

When selecting a physician, ask to see his or her credentials. Where was the physician educated? Is the physician board certified? What is his or her specialty? Does he or she have a history of malpractice?

Keep in mind that when you choose your primary care physician, your choice will often determine what specific group of doctors, specialists, and medical facilities to which you will have access. It is important to know where and with whom your doctor practices. Before selecting your physician, ask about the network of healthcare you are also selecting.

Most physicians are very busy people, but many are willing to make 10 or 15 minute appointments for prospective patients to interview them. Since communication is fundamental to a good physician-patient relationship, these interviews can be very valuable in helping you select the physician who will provide your healthcare.

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