Each insurance plan (also known as health plan) has its own network of providers: the doctors, other healthcare providers, pharmacies and/or facilities whose services it covers. Within the same health insurance company, there can be different networks for different plans – so be sure to look at your plan specifically. If the providers you need are not listed as in-network or participating, that doesn’t mean your insurance plan definitively won’t cover them (see question 8 below). However, it is a good idea to select a plan that lists your main providers as in-network.

IoIHS providers are in-network with many insurance plans. For a complete list, see here.

Each insurance plan has its own covered drug list: the medications it covers. Each plan also has coverage options: the services it covers. In your plan’s coverage options, under the category of “health,” you may see Acupuncture, Chiropractic, Massage Therapy, Maternal Care, dental, vision, or supplemental policies listed. It is a good idea to select a plan that lists the medications and services you consistently use in its covered drug list and coverage options, respectively. If you are not sure if a plan accommodates your specialized needs, the best way to confirm is to call your provider.

Just because a service is listed as covered doesn’t mean it is affordable to you. As such, it is important to know what your insurance plan is asking you to pay. Look out for the following terms:

A premium is the “base cost” you pay on a regular basis, typically monthly.

A deductible is the amount you pay for health services before your insurance begins to pay. For example, if your deductible is $500, you’ll pay 100% of eligible health care expenses until the bills total $500. After that, you share the cost with your insurance plan. In most cases, the higher a health plan’s deductible, the lower the premium. When you’re willing to pay more up front when you need care, you save on what you pay each month (refer to Blue Cross Blue Shield’s page on this).

Coinsurance and copayments are the cost-sharing arrangements you have with your insurance plan after you’ve paid your deductible. Coinsurance is a percentage of the total cost for a service while copay is a fixed amount.

Most insurance plans are required to cover a set of preventive services – like shots and screening tests – at no cost to you. See what preventive care services are covered without cost-sharing by your plan, such as Meditation, Yoga and/or Energy Healing. Also explore what additional benefits, like wellness programs or telemedicine, are covered.

Be sure to clarify how emergency coverage is handled by your plan, especially if you travel frequently. Emergency healthcare tends to cost the most.

Lastly, ask about your plan’s exclusions. Learn about any services or conditions that are not covered.

When you go to a doctor or provider who doesn’t take your insurance plan, they are considered out-of-network. Ask about what happens if you need care from a provider outside the network. Some plans may help pay for care from out-of-network providers while others do not.

Determine the facilities, clinics, and laboratories that are in-network according to your plan. Check if the insurance plan covers you in your preferred geographic region.

IoIHS providers are in-network with many insurance plans. For a complete list, see here.

Evaluate the insurance company's reputation for customer service and responsiveness. Research the provider's complaint history and dispute resolutions. Look into the company’s financial stability to ensure it can meet its obligations.