Shopping for insurance can be a maze of choices and you may need help narrowing your options. Focus on a few key areas to find plans that best match your needs.

Health benefits

Make a list of the health services you use now and determine what will be important in the future. Identify your must-have benefits and avoid the extras you won’t use. Some questions to ask when comparing benefits:

• How many doctor visits are allowed?
• Are preventive services and screenings covered?
• What benefits are available for children? i.e. immunizations, check-ups
• If you are planning to become pregnant, what maternity services are covered?
• Are prescription drugs included? (Check the plan’s formulary)
• Are emergency, urgent care and hospital services included?
• Are there limits on services? (Check for visit restrictions, annual dollar limits or separate deductibles.)

Costs

Determine which plans fall within your budget, taking into consideration premium, deductible and copays. Don’t forget about the out-of-pocket maximum as well. It may be easier to run through scenarios and determine what you would owe in certain situations:

• If I had an ear infection, saw my doctor and got a prescription, what would I owe?
• If I sprained my ankle and went to urgent care what would I owe?
• If I had surgery and the bill was $20,000 what would I owe?
• If I wanted to see an out-of-plan specialist, what would I owe?

Provider Network

Do you have a favorite doctor or clinic you would like to keep? You’ll need to check with each health insurance company to see if your doctor is in their network. Many plans also provide benefits for “out-of-plan” or “out-of-network” doctors and providers.

Additional Resources:

• Oregon.gov Individual Insurance Guide
• HealthCare.gov: Individual insurance and health reform
• Health Plan Comparison Worksheet

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How do your choices match up side-by-side?

Insurance plans vary in coverage and it can help if you see them side by side. This Health Insurance Plan Comparison Worksheet will help you compare costs and coverage for Providence Individual and Family Plan and any other plan you’re considering.

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