Health Plan Checklist

You have a right to be fully informed of the advantages and disadvantages of each health plan you consider. The choice you make may be one of the most important decisions you will face. Before selecting a health care plan be sure to ask a lot of questions.

The following checklist is designed to help you assess your needs when selecting a health care plan. By going through the checklist, you may find it easier to decide if a health care plan is right for you.

Coverage Comparison

Will the plan cover preexisting conditions?
Plan 1
Plan 2
Will the plan cover preventive care or wellness visits?
Plan 1
Plan 2
Will the plan cover preventive care or wellness visits?
Plan 1
Plan 2
Will the plan cover immunizations?
Plan 1
Plan 2
Is there a maximum amount the plan will pay per illness?
Plan 1
Plan 2
Is there a maximum lifetime amount the plan will pay for my family?
Plan 1
Plan 2
Will my child be covered while he or she is away at school?
Plan 1
Plan 2
Do I need pre-approval to see a doctor or go to the hospital when I'm out of town?
Plan 1
Plan 2
Does the plan limit the number of days of hospital stay for each illness?
Plan 1
Plan 2
Does the plan cover dental exams?
Plan 1
Plan 2
Does the plan cover dental expenses?
Plan 1
Plan 2
Does the plan cover the cost of eye glasses?
Plan 1
Plan 2
Is mental health treatment covered?
Plan 1
Plan 2
Can I choose my own obstetrician?
Plan 1
Plan 2
Can I choose my own pediatrician?
Plan 1
Plan 2
Can I choose my own family doctor?
Plan 1
Plan 2
Will I be allowed to change my doctor if I am not satisfied with the one I have?
Plan 1
Plan 2
Can I choose any hospital if I am sick or need treatment?
Plan 1
Plan 2
Must I get approval before going to the hospital or emergency room?
Plan 1
Plan 2
Must I get a second opinion before treatment?
Plan 1
Plan 2
Is the expense of a second opinion covered?
Plan 1
Plan 2
Will I be limited in the number of times I can visit the doctor?
Plan 1
Plan 2
Must I wait a specific amount of time after each visit before I can return to the doctor?
Plan 1
Plan 2
Will I have to pay an extra fee to see a specialist?
Plan 1
Plan 2
How long will I have to wait to get an appointment with a specialist?
Plan 1
Plan 2

Restrictions

Does the plan cover experimental treatments?
Plan 1
Plan 2
Will my doctor have access to all FDA approved medications orwill my doctor have to choose from a limited list of drug options?
Plan 1
Plan 2
Are prescription medications covered?
Plan 1
Plan 2
Are plan doctors provided financial incentives or disincentives in relation to their practice patterns?
Plan 1
Plan 2

Expenses

Is there a co-pay per doctor's visit?
Plan 1
Plan 2
Is there an extra charge for seeing a doctor outside the plan's provider network?
Plan 1
Plan 2
What is the monthly premium?
Plan 1
Plan 2
What is the deductible?
Plan 1
Plan 2
What is the lifetime maximum coverage per person?
Plan 1
Plan 2

Help

Is there an 800 number I can call if I have a question?
Plan 1
Plan 2
Is a patient ombudsman available to assist plan members?
Plan 1
Plan 2
Is a fair and open appeals process available if the plan refusesto pay for a treatment or service?
Plan 1
Plan 2
Will the plan respect advance directives and living wills?
Plan 1
Plan 2

Available Now!

The Pituitary Patient Resource Guide Sixth Edition is now available! Be one of the first to have the most up-to-date information. The Pituitary Patient Resource Guide a one of a kind publication intended as an invaluable source of information not only for patients but also their families, physicians, and all health care providers. It contains information on symptoms, proper testing, how to get a diagnosis, and the treatment options that are available. It also includes Pituitary Network Association’s patient resource listings for expert medical care.

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