If you don’t have a job or simply cannot afford the healthcare at your job then you probably know about the affordable care act. Otherwise known by some people as Obama Care. We know it can be very confusing, which is why we wanted to give you the tools to ask the right questions when deciding on your new plan. The ACA or Affordable Care Act can be very confusing, just like any insurance policy out there. So we put together 19 questions to ask when choosing a plan on the Affordable Care Act.
19 Questions To Ask When Choosing Your Affordable Care Act Plan
1. What deductibles are available?
2. How much is the monthly cost?
3. What is my maximum out of pocket cost?
You can use this as an example, you are involved in an auto accident, serious injury. Over $25,000. What is your maximum out of pocket?
4. What hospitals are in your provider network?
5. Do my preferred Doctors/Healthcare Providers belong to the network?
Example of what to ask: Ask about any specific doctor that you might want to use. If your doctor does not participate in their plan. Make sure you can find one that is conveniently located. Especially check OB/GYN availability. Ask for the link for the “Look for a Provider in Your Area” that you can use to check doctor availability.
6. What is my doctor office visit copay for preventative exams? Is it subject to the deductible?
7. What is my copay for sick visits to a physician? Is it subject to the deductible?
8. What is my copay for urgent care use? Is Urgent Care subject to the deductible?
9. What is my copay for Emergency Room use?
10. What is my copay for hospital stays?
11. What is covered in a preventative office visit? (Is lab work included?)
12. Are there any “out of network” benefits available in cases of emergency?
13. Are there any “out of network” benefits available while traveling?
14. Are prescription drugs covered? Separate deductible? Mandatory generic? Copays? Do any require prior authorization?
15. Will I need to get specialist referrals from my primary care physician? What about OB/GYN for pregnancy or well-woman care?
16. What if my provider leaves the network? Do I still continue with my provider or do have to switch to a new provider? (example, Pregnancy)
17. What are my responsibilities before and after going to the emergency room?
18. Is there any grace period for late premium payments?
19. Is there any reinstatement fee for late premium payments?
We hope that these 19 questions give you the tools that you didn’t have before and make choosing your plan a bit easier. At least you should be able to navigate the ACA a bit easier. If you have any questions please call us here at IASTL and we will be happy to help you!