Purchasing Medical/HMO Insurance
Jot Down the Key Points Important to Your Situation
Who needs to be covered? What are their ages and medical conditions? What are some of the important things you want coverage for? Check them off and assign each a number of from one to ten in importance.
– Routine doctor visits
– Annual check-ups
– Medical care for pre-existing conditions
Hospital – Lab – Treatment Services
– Diagnostic testing
– X-Rays, EKGs, biopsies , MRIs.
– Hospitalization coverage (type of room, specific benefits, duration of stay)
– Outpatient surgery
– Ambulance/Air ambulance services
– Pain treatment
– Rehabilitation services
– Cardiac care
– Radiation, bone marrow treatment and other cancer care
– Kidney dialysis and other treatment
– Organ and bone marrow transplants
– Inpatient services
– Rehabilitation, mental health, substance abuse facilities
– Dermatology orthopedics, neurology, ENT, urology
– Speech Therapy
– Learning disability issues
– Psychiatric care and treatment/Psychological counseling
– Dental services
– Orthodontics, periodontics oral surgery, orthogenatics
– Pap smears and mammography
– Newborn complications/care
– Family planning/fertility services
– Prescription drugs
– Vitamins and nutritional supplements
– Allergy treatment care and products
– Hearing aids and treatments
– Prosthetics and orthotics
– Durable medical equipment
Your Financial Situation
Ask yourself what your financial situation is and how would it be impacted by various types of medical problems? This will help you in evaluating different types of plans.
What kind of trade-offs do you want to make to save premium dollars? Choice of doctors? Higher deductibles? Limits on covered conditions and services? Agreeing to one-sided contractual requirements? Think about these things before you meet with an agent, so you are sure you will not forget to ask about them.
If you and your family members are simply not going to get sick, you might not want to have to pay for medical coverage at all. But if you want to be prepared, put yourself in the position of being ill. What kind of plan will you want to have in place from that perspective?
You should also keep all pamphlets, brochures or other promotional materials given or shown to you. Do not throw these notes or materials away. They could be worth thousands of dollars and more.
In discussing anything important about the coverage being offered, you should also ask to see the actual written plan or policy. Do this whether you understand everything in it, or not. If you note any discrepancies between the policy and what you have been told, inquire about them immediately.
If you obtain the information concerning your health coverage from your employer or your company’s human resources department, the same considerations in the section above apply.
Some HR representatives and employer representatives are more knowledgeable and experienced on coverage issues than others.
Next: Meeting with an Agent