Think about the following things when choosing a health plan. If you have questions or need specific information, call the health plan directly.
Differences Between Health Plans
All health plans offer the same basic benefits, but monthly premiums, providers, and some details of coverage may vary (such as which prescription drugs or preventive care services are covered).
Doctors or other Providers
Be sure to consider your choice of providers (doctors, clinics, hospitals, pharmacies, and other health care professionals), as well as monthly premium. Your current provider, or the providers nearest to you, may not contract with the lowest-cost health plan.
If you have a specific provider you would like to see, ask if he or she plans to participate with Basic Health and the health plan you’ve chosen. You should also confirm this with the health plan.
Some health plans may contract with provider groups, called subnetworks; this may limit your choice of providers. You may be required to see specialists or use facilities, such as hospitals, which are in the same subnetwork as your PCP. This means that even if a provider is listed with your health plan, the provider’s services may not be available to you unless the provider is also affiliated with your PCP. Call the health plan or your PCP to find out if your PCP can refer you to anyone listed as a provider with that health plan, or if your PCP can refer you to only a selected group of providers within the health plan.
If you take medications regularly, ask the health plan if it covers them. Be sure to ask the health plan about the cost of the specific drugs you are taking. Health plans do not all cover the same drugs.
If a Basic Health member changes health plans at any time during the year, the amount paid toward the deductible and out-of-pocket maximums for covered family members will start over with the new health plan.