What Should I Ask When Seeking a Plan?

The Affordable Care Act gives everyone more choices when shopping for a health insurance plan. It allows you to compare and shop for health coverage that meets your needs and fits your budget, whether you purchase directly through Blue Cross and Blue Shield of Texas, the Marketplace or a licensed insurance agent.

Open Enrollment for 2017 health insurance begins on Nov. 1, 2016 and runs through Jan. 31, 2017. You will need to decide if you are going to apply for a new Marketplace plan, keep your current plan or pick a new one. Just like making a major household purchase, like a car or a TV, there a few things you should do to prepare for buying health insurance.  Here are some questions you need to ask yourself as you seek a plan:

What provider network does the plan use?

• Is your doctor in the plan’s network?
• Have you checked to see if your doctor, specialists, hospitals or urgent care centers are in the plan’s network that you selected? You can use the BCBSTX Provider Finder  to check.

How often do you visit the doctor?

• Do you only get sick a few times per year?
• Do you have a health condition that means 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 take name-brand drugs that may cost you more each month? Drug coverage  may differ by plan. You can see the formulary, or drug lists, for each plan  we offer as well.

How much can you spend?

• An important question for many shoppers is “how much is health insurance?” Every plan is different, so before shopping, set a budget. How much will you be able to spend every month? Think about the monthly premium, but also keep in mind the deductible, copayments and other out-of-pocket costs to figure out what you could end up paying within a year, should you end up with unexpected medical bills. You can also use our subsidy calculator to see if you are eligible for financial assistance.

Do you need dental coverage?

• Some plans include dental coverage or you can buy a separate dental plan

What do the plans look like?
In the Marketplace, you can find plans in four levels — Bronze, Silver, Gold and Platinum. Here is a graphic that outlines the options.



Now that you know the questions to ask yourself, do you have any questions for us? If you're ready, start shopping now or, if you have questions call us at 888-731-0383 or log in and ask below!