Many people focus on premiums when they purchase a health insurance policy, as the policy's premium is how much must be paid every month to maintain coverage. However, this is far from the only thing you should consider when buying health insurance, though. Here are several other important questions to ask any time you get a new health insurance policy.

Routine check-ups are an essential component of preventative care, and federal law requires most health insurance policies fully cover these appointments. As long as you go to an in-network provider and have only a routine checkup, you should have no out-of-pocket expenses.

Insurance policies vary, however, in how often they will fully cover the cost of a checkup. Many policies include an annual appointment in their coverage, but some policies might have a different timeframe.

You should know how often your plan will cover an annual checkup so that you can take full advantage of this benefit without paying anything yourself. As soon as you are eligible for a fully covered appointment, schedule it with your primary care provider and review your general health with them.

What Are the Out-of-Pocket Expenses for Prescriptions?

You have two aspects to consider when looking at how your new health insurance policy treats prescription coverage. Both can greatly influence how much you end up paying for any medications you regularly take.

To start with, policies use a tiered system that dictates how specific medications are covered. Coverage for preferred medications is more generous than what is provided for non-preferred medications. You can obtain a list of what medications are preferred and which ones are non-preferred by talking to the agent who helped you select the policy.

Once you have the list of preferred and non-preferred medications, you can check what tier anything you take regularly is on. If any are not preferred, talk with your doctor about possible alternative medications that your insurer prefers. You may be able to switch to a preferred medication that the policy will cover better.

Next, check whether you pay a copayment or coinsurance. A copayment is a flat fee you pay and will not change with where you fill the prescription. A coinsurance is a percentage-based fee that will vary depending on what the pharmacy charges. If your policy has a coinsurance for medications, search for the most affordable pharmacy in your area.

Are Referrals Required for Specialist Visits?

Some health insurance policies require policyholders to obtain referrals before seeing a specialist, while other policies do not have such a condition. When a referral is needed, the patient's primary care provider usually furnishes it. Also, two reasons exist to find out whether your policy is one that requires a referral prior to seeing a specialist.

First, you should know your policy's referral requirements so that you can get medical attention from a specialist as quickly as possible if needed. If you need advanced care, you will not have to waste time looking at insurance information. You can immediately make the necessary appointment, whether that is directly with a specialist or your primary care provider for a referral.

Second, a policy that requires referrals for specialist appointments will slightly increase your out-ofpocket expenses for this type of care. In addition to the specialist copay, you will also need to pay a copay to first see your primary care provider. The added cost usually is not too much, but you should be aware of and prepared for it.

For help selecting a health insurance policy and reviewing all the pertinent details associated with it, contact American Quality Assurance Group.