When you go to the doctor’s office, you expect to have the visit covered, pay the co-pay, and have any drugs prescribed covered. You use a doctor inside the insurance company’s preferred network. What else do you need?

Health insurance involves the cost of a doctor outside the network without a referral, drugs that aren’t covered, out-of-pocket costs, and more. When you’re searching for the right Newark, NJ health insurance for you and your family, MSM Insurance Agency Inc. wants you to look for these things.

Health Insurance: What To Look For

Networks

Going to any old doctor when you’re sick will cost more. HMOs and PPOs prefer that you use their doctors. Their doctors prescribe drugs for which they will pay. You may or may not need a referral to see a specialist. This is called a network. If you use a doctor outside the insurance company’s network, you’ll pay more or all of it.

Paying For Healthcare

If you choose to pay higher premiums, then your out-of-pocket costs like copay and coinsurance will be lower. If you’re in the Newark, NJ ER or doctor’s office a lot, this would be a good idea. Alternatively, paying lower premiums with higher out-of-pocket costs would be better if you’re rarely sick and/or can’t pay the higher premiums. Also check if the plan covers specific medications such as diabetic meds, heart attack meds, and such.

Drugs

Prescription drugs are approved or not by insurance companies. They have a list of covered prescription drugs. Your primary care physician will fill out a form explaining why you need the drug before the insurance company will okay the prescription. If the medical need is severe, your doctor will file an exception with the insurance company.

Schedule A Consultation Today!

Figuring out health insurance is a matter of knowing what your needs are, what the insurance company covers, and how much you can afford to pay. MSM Insurance Agency Inc. is here for you when you have questions, so give us a call or drop by the office.