What to Look for in a Health Insurance Policy


As a consumer, it is your right and responsibility to review what a plan includes to ensure it meets your individual needs and lifestyle.

California residents who are in the market for health insurance make sure they are aware of what they are buying before they make a purchase. If a consumer is buying a plan through their employer or as an individual, they should always be aware of what is covered under the plan and what is. They should have a good estimation of what would happen to them financially in the event of various scenarios such as a chronic illness requiring long-term care or a catastrophic accident. This can be done by making sure you are familiar with the plan’s deductible, covered services, and out-of-pocket limits.

California health insurance consumers should also make sure they are aware of the types of preventive care covered under their plan. For example, at what age does the plan cover a mammogram for women? At what age does it cover a prostrate specific antigen test for men? Does the plan offer a website where you can find information about health conditions and symptoms? What types of prenatal care are offered? Does the plan offer coverage for vision benefits such as visits to the eye doctor, or for dental services?

Other questions to ask include: Does the plan offer prescription drug coverage, and if so does this coverage help pay for birth control pills? What doctors and providers are part of the plan? What will happen if you receive services out of network?

Does the plan offer support services such as counseling, drug and alcohol rehabilitative services, or an 800 number for assistance with personal issues? What types of treatment – for example, homeopathic - are excluded by the plan?

Knowing beforehand what to expect for their health insurance plan can help California health insurance consumers make the best choices.

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