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Questions to ask before choosing a health plan

Posted at 6:00 AM, Oct 29, 2019
and last updated 2019-10-30 17:45:23-04

By now, you're likely trying to decide which healthcare option is best for your family. It's enrollment time!

You may be talking to co-workers about which plan they use.

But Allen Gjersvig, with the Arizona Alliance for Community Health Centers, says that really shouldn't matter.

Gjersvig helps people decide if they qualify for free plans through AHCCCS or low-cost plans through the Healthcare Marketplace, and which one may be best for them.

Gjersvig says your needs may be completely different than your neighbor's needs.

He says to start by looking at last year's health plan and see if anything has changed.

Ask questions like what are known health needs in the family? Is there someone with a chronic health condition who sees many doctors, needs expensive tests and drugs?

Maybe you have young kids who see doctors more often. This may mean you need a more flexible Preferred Provider Organization plan (PPO) and not a Health Maintenance Organization plan (HMO).

They may also come with higher deductibles and premiums.

Gjersvig says if you're comfortable going to one primary care doctor for everything, then an HMO may meet your needs.

If you're a healthy family with few visits and no special needs, HMOs or some PPOs would work.

Always make sure doctors, hospitals, and medications you use are covered.

If you're self-employed, a short term policy could cover your needs.

It lasts a year, is inexpensive, but not for everybody.

Gjersvig says most short-term policies don't cover drugs, pregnancy, and are not going to give preventive cost coverage.

If you're healthy with few needs, they could cover you, especially in emergencies.

But Gjersvig says there are many limits and exclusions.

You don't qualify for a short-term plan if you have a pre-existing condition.

And Gjersvig says short-term policies are the number one complaint to thestate's department of insurance.

Before buying, know exactly what's covered.

Wednesday on ABC15 mornings at 6:30 a.m, we look at HSA and FSA's and show you which may be better for you.