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15 Questions to Ask Before Buying an Affordable Care Act Health Insurance Plan

November 22, 2017

Consumers face different healthcare needs at each phase of life. Health insurance needs vary if you’re single, if you have a family or you have chronic health conditions. This infographic looks at 15 critical questions to ask for each of the former situations when shopping for an Affordable Care Act (ACA) health plan.

Infographic Text

 

Here are critical questions to ask, based on your life circumstances when shopping for an ACA health plan.
For Single People
  • Do I meet the age or hardship requirements of a minimum coverage/catastrophic plan?
  • How often do I typically need healthcare each year?
  • What’s the full cost of the health plan, including premium, deductible and co-pays?
  • Based on my circumstances, is it better to have low premiums and more out-of-pocket costs, or more coverage and higher premiums?
For Families
  • What are out-of-pocket costs?
  • Should I choose an HMO, PPO, EPO or something else?
  • Are the kids’ pediatricians in the network?
  • Am I entitled to government subsidies for healthcare insurance? The Kaiser Family Foundation has a helpful screener.
  • Is it better for my family to have lower premiums and higher-out-of-pocket costs, or more health coverage and higher premiums?
For Those With Chronic Health Conditions
  • Are the prescription drugs I take covered?
  • Does an HMO, or EPO plan offer the best coverage for my condition?
  • Are my specialists in the network?
  • What are the deductibles and co-pay amounts?
  • How do the ACA health insurance plan levels work? Healthcare.gov has a great break-down of plan levels.
  • Considering my health condition and finances, is it better to have low premiums and more out-of-pocket costs, or more coverage and higher premiums? Often, those with a chronic condition actually save money with a higher premium—higher coverage plan.

Not all plan types are available in all states. To learn more about the ACA health plan options visit anthem.com, healthcare.gov, or your state marketplace.