What Should I Ask When Seeking a Plan?

What Should I Ask When Seeking a Plan?

What Should I Ask When Seeking a Plan?

Lee esto en EspañolThe Affordable Care Act gives everyone more choices when shopping for a health insurance plan. It allows you to compare and shop for health coverage that meets your needs and fits your budget, whether you purchase directly through Blue Cross and Blue Shield of New Mexico, the Marketplace or a licensed insurance agent.

Open Enrollment for health insurance begins on Nov. 1 and runs through Dec. 15. During this time, you’ll need to decide if you’re going to apply for a new individual or family plan, keep your current plan or pick a new one. Of course, as with any big purchase, like a car or a TV, there are a few things you should do to prepare before buying. As your search for health insurance coverage begins, ask yourself:

How much can you spend?

  • Every plan is different, so before shopping, set a budget. How much will you be able to spend every month? Think about the monthly premium, but also keep in mind the deductible, copayments and other out-of-pocket costs to figure out what you could end up paying within a year, should you have unexpected medical bills.
  • If you think you may be able to get financial assistance, use our subsidy calculator to check. You may qualify for a plan with a low premium.

What provider network does the plan use?

  • Have you checked to see if your doctor, specialists, hospitals or urgent care centers are in the plan’s network that you selected? You can use the BCBSNM Provider Finder to check.
  • Is your doctor in the plan’s network?

Do you take prescription drugs?

  • Can you take a generic drug, or do you take name-brand drugs that may cost you more each month? Drug coverage may differ by plan. You can see the formulary, or drug lists, for each plan we offer as well.
  • Note what the drug deductibles and copays are for each plan. If you take a lot of medicine for a health issue, you may be better off paying a slightly higher monthly premium to have lower drug costs.

How often do you visit the doctor?

  • Do you only get sick a few times per year?
  • Are you thinking about having a child?
  • Do you have a health condition that means frequent visits to the doctor or hospital?
  • Do you need dental coverage?
    • Some plans include dental coverage or you can buy a separate dental plan.

What do the plans look like?

  • There are many plans to choose from that can meet your needs and budget.
  • Visit the Shop Plans page on our website to learn more and shop for a plan that’s just right for you.

Now that you know the questions to ask yourself, do you have any questions for us? Call us at 888-809-1136 or log in and ask below.

Original publish November 9, 2016; Revised 2017-2020