February 2013
Managing Health Insurance
Manage your healthcare appointments/history/records. This website has an excellent set of checklists and forms.
U.S. Department of Health and Human Services
Access a question builder to help you prepare for your next doctor’s appointment.
Insurance
Know your own plan
- Services covered
- Participating healthcare providers and locations covered. In network versus out of network.
- Limits on the number of times certain services are covered and length of time you can use each service
- Cost-sharing, such as co-insurance, co-payments and deductibles.
- Coverage of inpatient care vs. outpatient care
- Are referrals and pre-approvals/pre-authorizations required and for what services
- Who is responsible for obtaining the referral
- What additional programs and services are available (i.e., disease management, wellness programs, exercise programs, chronic care programs, alternative medical therapies, preventive care, mail pharmacy)
Know other benefits available
- Flexible spending account
- Health savings account
- Health reimbursement account
During open enrollment period, consider, in addition to
- Are PCP and specialists in the network of plan
- Will the plan allow me to continue using the healthcare providers I am now using to treat my child?
- Will special services for my child be covered, like physical therapy, or mental health visits?
- Does the child’s doctor have the final say in referring to a specialist?
- Cost benefit of plans with high premiums or high deductibles
- Lifetime benefit maximums
