So you’re negotiating your salary and benefits package, and you’re told you’ll be covered through the company health insurance plan. Awesome, right? Don’t celebrate too fast – read the fine print and ask the right questions so you know that you aren’t getting yourself (or your family) into and health insurance surprises. Don’t be shy about asking HR the most important questions about what the health insurance they’re offering means, and which plan is right for you. Here are some of the most important questions to consider:
Is the plan you’re offering an HMO or PPO?
And by the way, what do HMO and PPO refer to anyways? In short, Health Maintenance Organizations (HMOs) give you access to certain doctors and hospitals within its network. A network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards. On the other hand, PPOs offer a wider network of providers and more coverage, but often come with a higher price tag. It depends on your specific situation to understand which option is right for you – just make sure you know what you’re getting into when you decide.
Does the plan cover special procedures and pre-existing conditions?
If you have a condition that you know you’ll need medical help for, or anyone in your family who will be covered under the plan for that matter, it’s important to understand how much coverage the plan is going to offer you. Ask plenty of questions in this vein about what’s covered, and what’s limited.
Is there a monthly premium? What about deductibles?
If there is a monthly premium, and if so, is it being deducted from the paycheck, or do you have to provide it in a different fashion? Is there a deductible, and if so, what things does it include, and to what level? These are really the essential questions when you are trying to find out what the health insurance policy is going to mean for your budget – especially if you foresee frequently paying a deductible for, say, prescription drugs.
What is the waiting period before the plan kicks in?
There can sometimes be a period of time you’re left without health insurance before the company brings you onto their plan. You can cover yourself by using a COBRA, which is a short-term health insurance policy. Talk to your employer about whether they have resources available in order to get you onto a COBRA.
What is the geographical coverage network like?
Does the plan apply only in the state you live in? Can you rely on it internationally? It’s important to find out what type of coverage you’ll get in different states. And remember that the network corresponds to the plan you have – not necessarily the umbrella company your insurance is coming from.
Is my current doctor covered under this plan?
If it’s important to you to keep seeing the doctor, remember to ask whether your doctor is covered over the new health plan. If they’re not sure, some insurers publish directories, but you can also find out through your doctor’s office or hospital.
If I’m not married, will the plan still cover my partner?
If the plan doesn’t have domestic coverage, you’ll need to talk to your partner about health insurance options for the two of you. This point is particularly pertinent for same-sex partners, who can still run into discriminatory policies on domestic coverage.
Do you have a summary of health insurance plans you’re offering?
Things can get especially confusing when your employer is offering multiple insurance plans. Unless you have one or two well-defined criteria that you can easily compare the plans on, you might want to make comparisons based on a summary, instead of delving into the fine print. Employers often have at least some sort of summary of the health insurance they provide, so see if HR can rustle one up for you.
Still have questions? Go to the experts for answers. Healthcare.gov offers a handy Q&A section to answer all of your questions about healthcare coverage. No matter what changes come in the future with the new presidential administration, you'll be ready and informed by checking this site.