Your healthcare matters
Your doctors matter.
Coverage is only useful if it works with the care you already rely on. Before reviewing any plan, it is worth knowing which physicians, facilities and pharmacies participate.
What to check
Consider participation before coverage.
Provider participation can change annually, even when nothing about your health has changed.
Physicians
Primary care and specialists you already trust.
Hospitals
The systems where you would receive care.
Pharmacies
Preferred pharmacies can change what you pay.
Skilled nursing facilities
Short-term rehabilitation settings.
Home health providers
Care delivered where you live.
Other healthcare facilities
Imaging, labs and outpatient centers.
Prescriptions
Your medications are part of the decision.
- Formularies
- The list of medications a plan covers.
- Drug tiers
- Where a medication sits determines your share of the cost.
- Preferred pharmacies
- Filling at a preferred pharmacy can lower your cost.
- Copays and coinsurance
- A flat amount, or a percentage of the drug cost.
- Prior authorization
- Some medications require approval before coverage applies.
- Quantity limits
- Plans may limit the amount covered at one time.
- Coverage changes
- Formularies are reviewed and updated each year.
