Please be patient while we create a copy of this decision for you...
| Name | Description |
| General Policy Terms | How satisfied are you with the basic coverage offered by this policy? |
| Cancellation by Insurer | Although prohibited in some states, does this plan have a provision allowing the insurer to cancel your policy upon written notice to you? |
| Cancellation for Non-Payment | If the insurer cancels your policy due to non-payment, is there an acceptable timeframe for receiving the written notice and for appealing the cancellation? |
| Coverage Duration | How does the timeframe this coverage is in force and any disqualifying events fit your needs? |
| Coverage Maximums | Does the amount of available insurance meet your current and future needs? |
| Coverage vs. Cost | Comparing the coverage this policy offers, is it offered at a competitive price? |
| Meets Your Need | Evaluate the degree to which this insurance policy meets your overall financial, health, life and liability needs both now and in the future. If you are not sure, ask a professional. |
| Policy Renewal | Is the plan or policy guaranteed to renew regardless of your current or future health status? |
| Insurance Agent | How would you rate your insurance agent's overall helpfulness and knowledge? |
| Agent Helpfulness | How would you rate the agent's understanding of your situation and ability to provide solutions from which to choose? |
| Agent Knowledge | Is the agent knowledgeable and able to answer all your questions? |
| Agent Relationship to Insured | Evaluate your reason for considering this policy; is it for emotional reasons, do you feel obligated due to a friendship or does the policy really compliment your financial goals? |
| Agent Status | Does the agent represent one company or many companies? With limited access to other insurers, premiums could be higher. |
| Insurance Provider | How would you rate the overall interest, information and support the insurance provider has given you? |
| Affiliations | Does the insurer have affiliations with other business concerns (e.g. business partnerships and working relationships) that might translate to reduced premiums? |
| Claims Processing | How easy is this insurer's overall claims process? |
| Company Rating | How is the insurer rated by the standard rating services? |
| Hospital Accessibility | How accessible are hospitals in this plan's network? |
| Physician Selection | Rate the number of physicians available under this plan for primary care in your area. |
| Physician Network | How well does the physician and specialist network in the plan meet your needs? (Consider out-of-area access, too.) |
| Plan Restrictions | Evaluate any restrictions the plan places on your choice of physician or specialist. |
| Recommendations | How would you rate the experience of others attempting to collect benefits from this insurer? |
| Specialists | What is your flexibility in choosing a specialist within the plan constraints? |
| Cost | How do you rate the overall cost of this insurance coverage? |
| Co-Pays | Rate the co-payments you must make for regular and specialist care. |
| Cost Management | Evaluate the options available to you to reduce your overall cost of coverage. |
| Ambulatory Surgery | Does this policy have an inducement to utilize less expensive, outpatient care in an effort to control costs? |
| Association Discount(s) | Evaluate any discounts given to policyholders for belonging to associations. (e.g. AARP, Alumni Association, Professional Associations) |
| Case Management | Does this policy provide for case management when dealing with large claims and numerous treatment options? |
| Mandatory Second Opinion | Does this policy contain a second opinion provision for non-life-threatening surgery? (This will reduce unnecessary expenses and therefore premiums paid.) |
| Multiple Policies | Does this plan stipulate that if you have additional insurance with another insurer, premiums for this plan will be adjusted and/or returned if they exceed the amount of prorated benefits? |
| Out-of-Network Costs | How reasonable are costs if you go outside this plan's network? |
| Pre-certification Review | Does this policy require a pre-certification review prior to hospital stays for non-emergencies? |
| Premiums | Rate your overall cost of insurance. |
| Affordability | Evaluate your ability to afford premiums based on current income. |
| Payment Frequency | Does the insurer provide payment intervals which meet your needs (monthly, quarterly, semi-annual, etc.)? |
| Payment Options | Does the insurer provide various payment options (EFT, check, credit card, etc)? |
| Payment Source | Have you evaluated the best way to pay for this coverage, whether it be cash from your income or cash from income producing investments? |
| Premium Amount | Rate the premiums being charged for this policy or plan. For higher limits and health risks, you would expect to pay a higher price. |
| Coverages | Evaluate the coverage afforded you by the health insurance policy or plan you are considering. |
| Adoption | What level of coverage is provided for adopted children in this plan? |
| Baby Well-care | Rate the level of preventative and post-natal newborn coverage in this plan. |
| Dental | What level of dental coverage does this plan offer you? |
| Emergency Services | Does this plan provide emergency care coverage outside of the network? |
| Family Planning | Does this plan provide coverage for family planning? |
| Maternity Benefits | Do the maternity benefits meet your specific family needs? |
| Mental Health Services | Does the plan cover mental health services? |
| Personal/Family | Does this plan provide coverage for everyone in your family who needs it? |
| Prescription Drugs | Rate the prescription drug coverage offered by this plan. |
| Vision | Rate the level of vision coverage offered by this plan. |
| Policy Features | Evaluate any limits placed on you due to policy definitions, eligibility or limitations. |
| Policy Considerations | Evaluate policy provisions to determine their impact on your out of pocket costs, coverage limits, or other policy terms. |
| Alternative Health Plans | Are other health plans an alternative in determining your overall health care needs? |
| COBRA | Explore your eligibility for coverage under COBRA. |
| Life Changes | Evaluate your coverage options for upcoming life changes, such as retirement, pregnancy, long-term care, etc... |
| Medicaid | Explore your eligibility for coverage under Medicaid. |
| Medicare | Explore your eligibility for coverage under Medicare, such as Types A, B, D, etc. |
| Unpaid Premiums | Is there an unpaid premium provision which states that if there is a premium due at the time of a claim, the unpaid premium will be subtracted from the benefit amount? (The alternative is policy cancellation or non-payment of the claim.) |
| Policy Eligibility | Do you fit the eligibility requirements for this policy? |
| Basic Eligibility | Given your known risk factors and your current or anticipated health situation, how do the policy eligibility requirements fit you? |
| Age Criteria | Are you within the required age range for this insurance policy? |
| Health History | Does your health history affect your ability to acquire this protection? |
| Income Minimums | Evaluate your income relative to your expected premium payment. Insurers will only issue policies to those who can afford the premiums. |
| Mental Conditions | If you have a prior or existing mental condition, are this policy's qualification criteria appropriate for your situation? |
| Occupational Risk | To what extent does your current occupation disqualify you for insurance or raise the premiums beyond affordable limits? |
| Pre-existing Conditions | How well are pre-existing conditions covered by the plan? |
| Adult Conditions | To what extent are adult related pre-existing conditions covered by the plan? |
| Child Conditions | To what extent are children's pre-existing conditions covered by the policy or plan? |
| Waiting Period | How reasonable are any waiting periods for your pre-existing conditions? |
| Recreational Risk | To what extent do your recreational activities affect your ability to obtain coverage with this provider? |
This site is intended as an informational tool only and should be used in consultation with appropriate professional advisors.
Please be patient while we create a copy of the 'Choose a Health Insurance Plan' scenario for you...
