Use this checklist to ask the right questions to avoid buying a medical plan your employees can't afford.
Are the services I need most covered?
Why this is important: Primary care, labs, generic Rx, chiropractors, annual exams, immunizations and routine xrays are the routine services over 90% of people need over 90% of the time. These services should be easy and have very few rules and costs associated with them.
- Are the copays reasonable?
Why this is important: The system has many ways to nickel and dime you. $0 copays for routine services are smart.
- Can I really afford the deductible?
Why this is important: Most people don't have $1000 saved. Never have a deductible that is higher than what you can pay.
- Will your insurance company promise to negotiate the best prices for me?
Why this is important: There are many "deals" being made between insurance companies and hospitals and drug companies that only benefit them.
- If I can find a price better than what the insurance negotiated, will they still cover it?
Why this is important: With the internet and new transparency laws it is easier than ever to get the lowest prices yourself or with a little guidance. Many traditional insurance plans force you to take their higher prices for prescriptions and services.
- Will my choice of doctors be limited by the insurance network?
Why this is important: Many insurance plans use limited doctor "networks" with high negotiated prices. If your Insurance uses networks still, ask them to disclose their negotiated prices for hospitals, drug companies and doctors. It's reasonable and it's the law.
- Will I be able to talk to my medical team any time of day or night so I don't have to miss work?
Why this is important: About 3/4 of medical services can happen over the phone or in video with no cost to you. Never accept the cost of unnecessarily missing time from work to refill a prescription, to get advice or to order an x-ray or MRI. Your time is valuable.