What should I do before I buy?


Before you buy a health insurance policy, make sure you understand what are buying.

  • Make sure you know what a plan will cover

    • Ask for the Summary of Benefits and Coverage-a standard form that will state exactly what the plan covers and what it does not cover. The plan must cover the 10 essential health benefits.

  • Make sure you know what it will cost

    • You pay for health insurance in two ways:

      • The monthly premium that you pay to purchase your plan.

      • The out-of-pocket expenses you pay when you receive medical care, which are usually a combination of deductibles, coinsurance, and copays.

You can learn more about the cost of care in our Managing Your Cost section of this guide.

  • Make sure you know the network -which doctors and hospitals are covered by the plan.

    • Every health insurance plan has a network of providers--doctors, hospitals, laboratories, imaging centers, and pharmacies that have signed contracts with the insurance company agreeing to provide their services to plan members at a specific price.

    • If a doctor is not in your plan's network, the insurance company may not cover the bill, or may require you to pay a much higher share of the cost. So if you have doctors you want to continue to see, you will want them to be in the plan's network.

  • Visit www.healthcare.gov, contact different insurance companies, or ask your licensed insurance agent to show you policies from several companies so you can compare them and decide which one is best for you. Carefully read and understand a policy before you sign up.
  • Make sure the policy states the date that the policy will begin paying (some have a waiting period before coverage begins), and what is covered or excluded from coverage.
  • Review the information provided about the evaluation period - plans are required to have an evaluation period for 30 days.  Make sure you understand what that will mean for you.