Millions of Americans are offered a choice of health plans through their employers, but the question is —What makes a good health care plan? Here are some things to consider when choosing a health plan.
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Are you choosing a plan simply because it is the cheapest? This may not be the best way to go. Some inexpensive plans have a high deductible and no comprehensive coverage. |
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Is the plan accredited by the National Committee on Quality Assurance? This is a good indicator of quality. |
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Are your current doctors and specialists in the plan? If not, make sure you will be able to see a certain provider or specialist, such as a physical therapist, without too much added expense and difficulty. |
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Is physical therapy coverage adequate? If you should have an injury or illness requiring rehabilitation, you will need a plan that offers an unlimited number of visits to a physical therapist or that allows for the number of visits to be extended if needed. |
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Are there lifetime limits on benefits? If so, you could face a serious financial crisis if you or a covered member of your family suffers a major illness or injury. |
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Does the plan have an out-of-pocket maximum? In this case, once you have paid a certain amount (usually several thousand dollars) the plan would cover the rest. |
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How does the plan handle grievances and appeals? The procedure should be simple, timely, and accessible. |
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Does the plan permit use of outside doctors, specialists, or hospitals? Called "point-of-service" option, this would allow you to see a provider, such as a physical therapist, who is not in your plan. There may be an additional cost, but it may be worth it. |
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What is the plan's disenrollment rate? A high rate of members leaving the plan annually may indicate customer dissatisfaction. |