How to review your health insurance policy: 5 useful tips

When it’s time to renew your health insurance policy, what should you look for?

In most cases, you’ll review your health insurance policy, evaluate your options, and choose a plan during Open Enrollment beginning on November 1, for coverage beginning Jan. 1.¹

Maybe you’ll renew your existing health insurance policy.
Or maybe some things have changed in your life (like getting married, having a baby, or getting a diagnosis you need ongoing treatment for) and you need to find a different plan.

Even if you’re happy with your current health insurance policy, the Open Enrollment period is a good time to look over your policy and take note of any changes that might affect you.

These 5 useful tips will help you review your health insurance policy and choose a plan that’s right for you.

Here’s what you need to know…

1. Review your coverage

Think about the services you’ve used in the past year.

Overall, were you happy with your coverage?

Check to make sure that the services you used will still be covered in the upcoming year.

If your health has declined or you anticipate needing additional services, review your policy to see if these are covered.

Your summary of benefits

Still not sure where to start? Health insurance plans are required to provide you with a Summary of Benefits and Coverage.²

It’s a useful document that explains what your health plan includes, written in easy-to-understand language. And it’s a good place to start to review your health insurance policy.

You should review this as well as the rest of your health insurance policy to ensure that the plan you had last year will still fit your needs for the upcoming year.

2. Review your costs

At a glance, you might think your health insurance policy monthly premium is all that really matters to compare plans. But there are other costs to consider.

When you evaluate your health insurance policy and compare other plans, look at costs including:³

Premiums
Deductibles
Co-pays
Out-of-pocket maximums
Prescription drug costs

Compare your total costs for the year with other plans. Would a new plan save you money and still provide the care you need?

3. Evaluate your healthcare providers

Do you like your doctor? Will your doctor still be included in your insurance company’s network if you renew your existing plan?

Maybe your doctor is moving or retiring.⁴
Maybe your doctor isn’t part of your insurance company’s network anymore.
Or maybe you weren’t satisfied with the care you received.

When you review your health insurance policy, it’s a good idea to evaluate your healthcare providers.

Here are a few questions to consider:

Was it easy to get appointments?
Did you have to get referrals for specific tests or procedures?
Were you happy with the process?
Are clinics, specialty offices, and a hospital easy to get to from where you live?

If you’re satisfied your healthcare providers, renewing your existing plan might make sense.

But if there are things you’d like to change, reviewing your health insurance policy and comparing other plans may improve your level of care.

4. Compare prescription drug costs

Things can change. If you’re taking prescription medications, will the drugs you need still be covered under your insurance plan?

It’s best to make sure during Open Enrollment that you will have the coverage you need, including coverage on the medications you are taking or might be taking in the future.5

Additionally, you should see if there are any new coverage rules that might apply to your prescriptions.

Not sure if your prescription drugs are covered?

Check your health insurance plan’s website for a list of prescriptions the plan covers, or…
Contact your health plan directly and ask for help to verify your prescription drug coverage

5. Rate your overall healthcare experience

Think back to your experiences with doctors, hospitals, pharmacies, and of course, your health insurance carrier over the past year.

What did you like or dislike?
Was it a smooth process from start to finish, from booking an appointment to getting care, filling prescriptions, or calling your health plan’s office about a billing question?
Will programs you participate in (like health coaching), continue in the upcoming year?

If there were things you wanted but didn’t have—for example, electronic health records, or mail-order prescriptions, or your experience wasn’t the best, it makes sense to review your health insurance policy and consider all your options.

Choose a health insurance policy that works for you

There’s so much to think about when choosing a health insurance policy, even if you decide to stay with the policy you used last year.

No one wants to be hit with unexpected charges, or find out that they need to switch doctors after finally getting comfortable. Right?

Want some help reviewing your health insurance policy and your options?

We can help. You can compare plans online, talk with a license health insurance agent by phone at (800) 827-9990, or find one in your area.