Health Insurance Coverage Discussion

Q1- Define the term “co-insurance.” Where does co-insurance apply within your coverage? How does co-insurance differ from co-pay

Q2- Are you required to identify a Primary Care Physician (PCP) when you enroll? Do you have a PCP? How did you choose your PCP? If you do not have a PCP– why not?

Q3- Where does pre-certification or pre-authorization apply within your coverage? How does this requirement impact your decision to access healthcare?

Q4- Describe the use of a formulary when a policy has pharmacy benefits. Does your coverage provide a forumlary?

Q5- What, if any, wellness benefits are covered in your plan? Do you access them? There is no wellness benefits are covered in my plan

Q6- What is meant when a policy has “out of network” stipulations. Does this impact your decision to access out of network healthcare?