10 tips for choosing a new health insurance plan

Consider your medical history, ongoing treatments, and potential future health care needs. 

Regardless of your medical history, many preventive care services are covered at 100% – meaning your plan covers them at no extra cost. Preventive care³ is routine health care that includes screenings, checkups, and patient counseling to help prevent illnesses, disease, and other health problems.

To avoid extra costs, it's important to know what qualifies as preventive care and what questions to ask your doctor.  

There are a couple common types of insurance coverage for you to consider.

For example, a preferred provider organization (PPO) health plan contracts with medical providers to create a broad network of participating providers. You can access out-of-network care at a higher cost. Plus, you may or may not need a referral to specialists. 

Meanwhile, a health maintenance organization (HMO) plan requires patients to receive care from a specific group of doctors. Typically, it will not cover out-of-network care except in an emergency. Plans can be specific to a service area based on where you work or live. You will need referrals from your primary care provider (PCP) for specialists. 

When choosing your plan, consider your health care needs for the upcoming year.

With some plans, the premium amount you pay monthly may be more or less, while the amount you have to pay for covered care and services will vary as well. Look beyond premiums – consider deductibles, copayments, and out-of-pocket maximums.  

In addition to the essential health benefits that address physical health, it is important to also look at coverage for mental health and substance use disorder services. This includes behavioral health treatment, such as counseling and psychiatry services. 

Many health plans now include educational programs and coaching to support healthy choices in food, physical activity, sleep, and stress management. You may even receive free or discounted exercise classes and health technology like wearables. 

Make sure to explore the many benefits included with your coverage. Check for in-network providers, read reviews, and compare deductible and out-of-pocket costs. 

If you need dental coverage or vision benefits, check into the various offerings available as an additional plan to your medical coverage.

Ensure your preferred doctors and hospitals are covered in the plan's network by using our Find Care tool⁴. Your health plan will encourage you to choose an in-network PCP who will be the captain of your care team. When you see the same provider regularly, you can get to know each other, feel more comfortable when you need something, and get trusted referrals when needed.

Prescription drug costs can add up quickly. When choosing health insurance, it's essential to closely assess the prescription coverage offered by different plans.

Start by compiling a list of your current medications and their dosages. Check the formulary, or list of covered drugs, for each plan to ensure your medications are included, noting any tiered pricing that might affect your out-of-pocket costs. Our drug search tool⁴ tells you which drugs are covered, as well as which need prior authorization.

Having health insurance means you can stress less about life's unexpected moments, in addition to knowing you have access to preventive care to help you live your healthiest life. 

The right benefits and support will help you navigate the complexities of health care with confidence. If you have more questions or want to talk about your specific needs, visit one of our Blue Cross NC Centers.