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Deciding What Benefits You Need

You want a health plan to cover the services you need, or may need in the future. But you don't need a plan to cover services you'll never or rarely use. Think about your family. Will you need maternity benefits? Do you spend a lot of money on prescription drugs? Do you or anyone in your family have a chronic illness? Think about the questions below to help you decide which plan is best for you and your family. The following list includes the types of benefits offered by many plans.

Preventive Care

  • Is the plan focused on keeping you healthy?
  • Which plan offers the best coverage for
    health maintenance visitsA periodic evaluation with your health care provider.
    for adults and children?

Vision Care

  • Does the plan include vision care?
  • Does it cover yearly eye exams?
  • Does it cover some or all of the cost of glasses or contact lenses?

Maternity Benefits

Are you pregnant or thinking about starting a family soon? While the state requires maternity coverage, some plans may offer more comprehensive benefits than others. You will need coverage for:
  • Doctor's visits
  • Ultrasounds and others tests
  • Your hospital stay
  • Checkups and tests for your new baby
  • Prescription drugs

Care for Current Medical Conditions

  • Does the plan cover costs for conditions you already have, such as high blood pressure or diabetes?
  • Are there limits on coverage for
    pre-existing conditions?A health condition you have been diagnosed with before enrolling in your health plan. Examples include diabetes and heart disease.

Prescription Drug Coverage

  • Does the plan cover prescriptions?
  • Do you or anyone in your family use a lot of prescription medicines?
  • How much do you have to pay out of your pocket (as a copay for example)?
  • Are there restrictions on which medicines are covered?
  • Is there a mail-order program for ongoing prescriptions?

Mental Health Benefits

  • What mental health services are covered?
  • Does the plan cover visits to a psychologist or psychiatrist?
  • Does it cover drug and alcohol rehabilitation services?
  • Does it cover prescription drugs?

Dental Care

Dental health is a key piece of your overall health. Some health insurance plans include dental coverage as part of your benefits package. If not, you may have the option of purchasing separate dental insurance.

 

  • Does the plan include dental benefits?
  • What kind of dental services does it cover?
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