What Should I Ask When Shopping for a Plan?

What Should I Ask When Shopping for a Plan?

What Should I Ask When Shopping for a Plan?
2 minute read time

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You now have more choices than ever when it comes to health insurance plans. Whether you buy directly from Blue Cross and Blue Shield of Texas, the Health Insurance Marketplace or a licensed insurance agent, it’s easy to compare plans and choose one that meets your needs and fits your budget.

Open enrollment for health insurance starts on Nov. 1 and runs through Jan. 15, 2025. When you sign up by Dec. 15. your coverage will start on Jan. 1, 2025. Of course, you’ll need to decide if you want to keep your current plan, apply for a new individual or family plan, or choose a different type of plan.

As with any big purchase, there are a few things you can do to prepare before buying. As you search for health insurance coverage, keep these questions in mind.

What provider network does the plan use?

  • Is your current doctor in the plan’s network and is this important to you?
  • Are the specialists, hospitals or urgent care centers you use in network for the plan you want? Use the BCBSTX Provider Finder® to check.

How often do you visit the doctor?

  • Do you only get sick two or three times during the year?
  • Do you have a health condition that requires frequent visits to the doctor or hospital?
  • Are you thinking about having a child?

Do you take prescription drugs?

  • Can you take a generic drug, or do you need a name-brand drug that may cost more? Drug coverage may differ by plan. You can review the formulary — or drug lists — for each plan we offer.
  • Note the deductibles and copays for each drug plan. If you take a lot of medicine for a health issue, it may be better to pay a slightly higher monthly premium in exchange for lower drug costs.

How much can you spend?

  • Every plan is different, so before you shop, figure out your budget. How much will you be able to spend every month? Think about your monthly premium, but also keep in mind the deductible, copayments and other out-of-pocket costsDoing so will help you figure out what you could pay during the year if you have unexpected medical bills. 
  • If you think you may be able to get financial assistance, use our premium tax credit calculator to check. You may qualify for a plan with a low premium.

Do you need dental coverage?

  • Some plans include dental coverage. With others, you can buy a separate dental plan.
  • If you know you will need a lot of dental work next year, such as an implant or kid’s braces, you may want to add a Health Spending Account to cover out-of-pocket costs.

What do the plans look like?

  • There are many plans to choose from that can meet your needs and budget.
  • Go to the Shop Our Plans page on our website to find one that’s just right for you.

Now that you know what to ask, do you have any questions for us? Call us at 1-888-731-0383 or log in to ask!

Original publish December 3, 2014; Revised 2015-2021, 2023, 2024