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5 questions to ask before picking a health insurance plan November 08, 2024 Open Enrollment Health Insurance Basics 3 MINUTE READ

Health insurance can be complicated. Whether you’re purchasing health insurance for the first time or just need some help navigating the Health Insurance Marketplace®, we have the answers to your most pressing questions.

1. When can you buy health insurance?

If you buy your health insurance through the marketplace, not through your employer, there are a few times you’re able to purchase a plan. The first is during Open Enrollment, which occurs each November.

The second is if you experience a qualifying life event1. These are things like getting married, changing jobs or having a baby. If you experience one of these events, your health insurance enrollment options reopen, and you can reselect or choose a different plan.

2. Why do you need health insurance?

Health insurance is like a safety net. You may not need it, but in the event you do, you’re happy to have it. No one expects to get sick or have surprise medical bills, but having health insurance can give you peace of mind. In fact, you may even be surprised at all the ways health insurance can help you save and all the things it may cover.

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3. How much coverage do you think you’ll need?

Consider your personal health needs and the amount of care you typically use.

A bronze plan is good for people who want protection from worst-case medical scenarios, like a serious illness or injury. This type of plan can have low monthly premiums but pays less of your costs when you need care.

A silver or gold plan will have higher monthly premiums. These plans will cover more of your routine care and regular prescription drug costs.

4. What are the costs associated with each plan?

When shopping for a plan, there are two types of costs to consider. One is your premium, or the amount that you pay your insurance company each month.

The second is your out-of-pocket expenses. These are things like copays, deductibles and any other costs not covered by your insurance plan.

Together these costs make up your total health care expenses. It’s important to consider both your monthly payment and your expected medical expenses when choosing a plan.

Many people and families qualify for savings or a subsidy on their monthly premiums based on income. Find out if you qualify for savings and apply for your subsidy2.

5. Which doctors do you see?

Check to see if any doctors you regularly use are in-network for the plan you’re considering. This is important because seeing in-network doctors will cost you less than seeing out-of-network doctors.

Remember that with Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you’ll never need a referral to see a specialist. As part of our efforts to keep costs down, Blue Cross NC works closely with many North Carolina hospitals and physicians to help get you access to quality, affordable care, when you need it.

When shopping for health insurance, look for a plan that:

  1. Makes sense with your medical history and health care needs, including prescription medications.
  2. Works for you financially, thinking about both monthly premiums and out-of-pocket costs.
  3. Includes your regular doctors in its network.
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