How to choose a health plan
Questions to ask before you sign up for a health plan.
1. Does the plan include my doctor, clinic and hospital?
A health plan works with a network — a group of doctors, clinics, hospitals and other healthcare professionals. Usually, you pay less when you see a provider in your plan network. Be sure to find out if your providers are in the plan network before you enroll. You will pay more for services you receive outside your network. Learn more about networks.
2. Does the plan cover my ongoing medical needs?
Consider the type of coverage you'll need for treatments you will start or continue in the future. Find out if the plan covers the services you need, and if it will cover them as often as you need them.
3. Does the health plan cover me while traveling?
Some health plans have networks that include providers throughout Minnesota. Others include providers in specific counties. If you need healthcare outside of your plan’s service area, you might not have coverage.
4. Does the plan work with a health savings account (HSA)?
Some health plans include HSAs that you can use to save and pay for healthcare. Learn how a health savings account works.
5. Does the plan cover my prescription drugs?
Prescription drug coverage varies by health plan. For example, some plans have a copay or coinsurance for covered drugs. This means you pay part of the cost for covered drugs and the plan pays the rest. With some health plans, you must first pay a deductible before the plan begins to pay.
Generally, health plans have a list of drugs they cover. This list is known as a formulary. Typically, plans will not cover drugs that are not on the formulary. Be sure to check the plan formulary to make sure the plan covers the drugs you take.
6. Is my pharmacy in the network?
Health plan networks usually include several pharmacies where you can fill prescriptions. Check to make sure the pharmacy you prefer is in the plan network. If you visit a pharmacy outside the plan network, you will pay more — and possibly the full cost — for your prescription drugs.
7. Does the plan offer support to help me make decisions about my health?
Taking care of your health is important. Find out what tools and support the plan offers to help you get and stay healthy. Here are a few questions to ask:
- What tools and resources does the plan offer to help you stay healthy and keep medical costs down?
- Does the plan offer online doctor care?
- Are there tools to help you compare costs and quality of doctors and hospitals, so you can find the best value?
Shop plans
Choose the plan that's right for you, whether you want to cover yourself, your family or your employees.
This is general information about how plan benefits work. Review the Summary of Benefits and Coverage and your specific health plan benefit booklet for information about how your plan works.
It’s up to you to always check if your provider is in your health plan network before you receive services. Not all providers are in every network. You may pay more or for all of your healthcare costs if your provider is out of your network or does not have a contract with Blue Cross (this is called a non-participating provider). You can verify if your provider is in your network by calling customer service at the number on the back of your member ID card.