How to pick a health insurance plan
Choosing the right health insurance plan for you and your family is one of the most important things you can do to protect your health and financial well-being. When shopping for a plan, you want to know what to look for so you can get the most for your money while also having a plan that fits your needs and lifestyle.
As you explore your options, here are a few questions to consider.
What are my monthly premiums?
To maintain your coverage, you’ll be required to pay a monthly fee known as your premium. Make sure this amount stays within your budget. You’ll also want to know what you may be required to pay toward the monthly premiums of a spouse or dependent covered under your plan.
What are my deductible, copayments, coinsurance and out-of-pocket maximums?
These types of cost-sharing only come into play when you receive medical care. It’s important to ensure you can afford these amounts for routine care and when a serious or unexpected medical event occurs.
- Deductible: The amount of money you pay out-of-pocket before your insurance company begins paying for covered health care services.
- Copayments: The percentage of costs you pay for certain services and after you meet your deductible. Your insurance company pays the remaining amount.
- Coinsurance: This is the percentage of costs you are responsible to pay for certain services, and the percentage you pay after you meet the deductible; the insurance company pays the rest
- Maximum out-of-pocket: The maximum dollar amount you’ll pay for health care in a plan year. Your insurance company pays the costs of covered charges after this amount.
Is my doctor in the health plan’s network?
If you have a preferred doctor or hospital, make sure they are in-network before choosing a plan, or your claims may be denied or paid at a lower level. Your health plan should have tools to help you check which plans your doctor accepts.
Are my prescriptions covered?
Some plans cover different prescription drugs than others, and some plans pay more toward prescription drugs than others. Sanford Health Plan has a prescription drug coverage comparison tool so you can see what you’re estimated to pay based on your prescription needs.
What perks and discounts are offered?
Discounts can add up to savings, putting more money back in your pocket. At Sanford Health Plan, we go beyond health insurance coverage by giving our members access to a variety of discounts for vision, dental, hearing, nutrition and weight loss services. We also offer virtual care at no cost under certain plans and monthly gym reimbursements at participating facilities for specified plans.
Current Sanford Health Plan members can access their summary of benefits and coverage using our secure member portal or by contacting customer service using the number listed on the back of their member ID card.