Personal insurance
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Understanding your options
Health plans differ in their provider networks, covered services, prescription lists and costs. Compare the monthly premium with what you may pay when you receive care, and check the actual plan documents before enrolling.
Coverage, eligibility, limits and exclusions depend on the insurer and policy. Review the actual policy documents before making a decision.
A closer look
The premium is the recurring cost of the plan. Depending on the benefit, you may also pay a deductible, copay or coinsurance. Review the out-of-pocket maximum and which covered services count toward it; premiums and services the plan does not cover generally do not count.
Check that the specific plan includes your doctors, hospitals and medicines, and review referral and prior authorization rules. Coverage and costs can differ for in-network and out-of-network care. Verify details with the plan and provider because directories and benefits can change.
Plan types have different eligibility and enrollment rules. Ask which enrollment period applies and whether a life event creates an opportunity to enroll or change coverage. For an initial conversation, describe the number of people and general timing; do not send medical history through the website.
Before you reach out
Common questions
Compare premiums alongside deductibles, copays, coinsurance and the out-of-pocket maximum for covered care. Review the plan’s benefits, exclusions, network, prescription list and referral rules rather than choosing on premium alone.
Check the specific plan’s current provider directory and benefit documents, then confirm network participation with the plan and provider before receiving care. A provider may participate in some plans from an insurer but not others.
A deductible is the amount you pay for applicable covered services before the plan begins paying its share. A copay is a fixed amount for a covered service. Some services may be covered before the deductible; the plan explains its rules.
It is the plan’s limit on certain costs you pay for covered services during the plan year. Premiums and costs the plan does not cover generally do not count. Check the plan for network rules and what counts toward the limit.
Enrollment depends on the type of plan and the applicable enrollment period. Some life events may qualify a person for a special enrollment period. Ask about your situation and deadlines before making a change.
Start a conversation
Share a few basic details and the team can help you take the next step. Please leave sensitive information out of this first message.
