Choosing a Health Plan

You can view a summary of a plan's benefits and coverage and a glossary of commonly used terms before you enroll and each year when your plan renews. These documents explain your benefits and coverage limits in clear, easy-to-understand language.

• Most health plans must cover preventive services with no cost-sharing.
• All comprehensive health plans issued after January 1, 2014 must offer essential health benefits.

Questions to Consider

Here are some things to consider when comparing plans.

• What are the premium, copayment, deductibles, coinsurance, and out-of-pocket limit amounts?
• When do you need to pay the above amounts?
• What types of care does the plan exclude?
• Are your prescriptions on the list of covered drugs? What do they cost?
• Are your providers (doctors, hospitals, specialists, pharmacies, etc.) in the plan's network?
• Are there limits on the number of times you can receive a specific type of care?
• Do you need a referral or pre-authorization before you can get treatment for certain types of care?