Health Insurance

  1. What to Ask when Shopping for Health Insurance
  2. Phone and Online Solicitations
  3. Plan-Specific Questions
Getting the right information can help you choose the right health insurance for you and your family. Here are some questions to ask yourself before you start to look for insurance and some questions to ask anyone who offers you coverage.  

We all know health insurance can be complicated. There are differences in what is covered and what you will have to pay out of pocket. 

With so many options and information out there, it makes it even more difficult to sort through when you get solicited for health insurance online or by phone. Scammers like the anonymity of telemarketing and take advantage of that confusion. Check out Phone and Online Solicitations section above. This section offers some simple questions you can ask so that you are not taken advantage of by a scammer.   

If you need help to understand health insurance, you can visit with a licensed insurance agent or a navigator. You can find definitions of health insurance terms on healthcare.gov, the Federal Marketplace for health insurance. If you’re a senior, you can contact the South Carolina Department on Aging or call 1-800-MEDICARE to talk to someone about health insurance for seniors. 

Questions to ask yourself

Why it’s important

Why do you need health insurance?

Life is full of surprises. Insurance helps you prepare for the unexpected, like an accident or an illness. A single trip to an emergency room can lead to a bill of thousands of dollars.

Is the plan with the lowest premium really the most affordable?

Plans with lower premiums often have more limited benefits. You should consider not only the cost of premiums, but also how much you’ll pay out-of- pocket when you need health care.

Who are you buying health insurance for?

You might need coverage just for yourself, just for a family member, or for the whole family.

How long do you need health insurance – a full year or for a few months?

Some plans might be limited to a few months. Others will cover you for an entire year and then that coverage can be renewed.

Do you have a known health condition (a pre-existing condition)?

Even if you look and feel healthy, you may not be getting the routine care necessary to identify the unexpected. Thinking about your family health history, your current health conditions, prescription drugs you may need, and the health services you need will help you understand the coverage you want. But remember, accidents and unexpected illnesses happen, so you might need services you don’t expect.

Many plans cover services to treat pre-existing conditions, but some don’t.

What prescription drugs do you need?

Do you have any chronic health conditions, like high blood pressure, diabetes or an autoimmune disorder? Even if you haven’t been to a doctor, are you in pain or having problems you believe will result in any health care services or treatment?

Do you have a family doctor or hospital?

You’ll pay less to see providers that accept your health insurance – which may not include your family doctor or hospital. The terms to know are “in-network’, “tiered network”, “non-participating” and “out of network.” Many plans pay more of the costs for services you get from doctors or facilities in the plan’s network.

Are you ready to pay the full cost for services until a deductible is reached?

The deductible is the amount you pay before your insurance company starts paying their share of the cost of care. Even with insurance, you pay the full cost of services until you meet your plan’s deductible.

Are you able to pay the full cost for services if the plan limits how much it will pay?

Some plans only pay up to a certain dollar amount; you may have to pay the cost beyond that amount.