Will Healthcare Change? Examining the Future of the U.S. Healthcare System

Will Healthcare Change?

Healthcare in the United States has been a long-standing subject of debate. From policy reforms to administrative practices, the question remains: Will healthcare ever truly change for the better? Recent controversies, including the tragic assassination of UnitedHealthcare CEO Brian Thompson, have reignited conversations about systemic issues and potential reforms in the industry.

Industry Leadership and Accountability

Healthcare industry leadership has a profound influence on the patient experience, with executives shaping policies that affect accessibility, affordability, and overall care quality. The recent controversies surrounding UnitedHealthcare CEO Brian Thompson’s 2023 salary underscore growing public frustration over perceived misalignment between corporate priorities and patient needs.

Critics argue that high executive salaries and bonuses often reflect profit-driven strategies rather than investments in care improvements. For instance, claims denials and network restrictions frequently impact patients’ access to necessary treatments, fueling distrust toward large insurers.

While healthcare CEOs face significant challenges in managing costs, balancing shareholder expectations, and navigating regulations, accountability to patients must remain a priority. Greater transparency in executive compensation—including disclosures on performance-based metrics tied to patient outcomes—could rebuild trust and demonstrate a commitment to ethical leadership.

Moreover, the lack of diversity in leadership teams within the healthcare industry has also come under scrutiny. Expanding representation could help better address the needs of underserved communities and foster policies more aligned with the realities faced by diverse patient populations.

The tragic circumstances of Thompson’s death, coupled with the public response, have brought these tensions into sharper focus. For real change to occur, industry leaders must shift the narrative, champion reforms, and demonstrate genuine accountability. Patients, after all, deserve a system where decisions prioritize their health above all else.

The Claims Process: A Reflection of Systemic Issues

The healthcare claims process often feels like a battleground for patients. Insurers manage millions of claims annually, juggling cost controls, regulatory compliance, and profitability. However, these processes frequently leave patients facing delayed or denied care.

UnitedHealthcare’s post-crisis surge in claims approvals has sparked discussions about how bureaucratic hurdles in the claims process impact care delivery. Patients have long criticized insurers for opaque criteria, seemingly arbitrary denials, and lengthy appeals. This situation underscores a deeper issue: administrative inefficiencies that prioritize cost savings over patient outcomes.

For example, many claims require pre-authorization, a process where insurers decide whether a procedure or service is "medically necessary." While intended to prevent wasteful spending, this often leads to delayed treatments and frustration for patients and providers. Mental health services, in particular, see disproportionate denials, leaving those seeking care at the mercy of a system riddled with inconsistencies.

The claims process disproportionately affects vulnerable populations, including those reliant on Medicaid or subsidized ACA plans, where administrative errors or delays can mean lapses in coverage. The tragedy surrounding UnitedHealthcare has shone a spotlight on these practices, urging insurers to reconsider the human impact of their policies.

Streamlining the claims process involves:

1. Improving transparency by offering clear explanations for denials and accessible appeals.

2. Reducing administrative hurdles through automation and simplifying pre-authorization requirements.

3. Tracking patient outcomes and tying claims practices to real-world care improvements.

As the healthcare system grapples with evolving public demands, addressing the claims process is essential for rebuilding trust and ensuring equitable access to care. By putting patients first, insurers have an opportunity to move the industry toward a more compassionate and effective model.HMO vs. PPO: A Decision with Lasting Impact

For everyday Americans, the choice between an HMO (Health Maintenance Organization) and a PPO (Preferred Provider Organization) can significantly affect access to care. While HMOs offer lower premiums and focus on primary care referrals, PPOs provide flexibility in choosing specialists but often come with higher copayments. Both models face scrutiny for limiting patient access and increasing out-of-pocket costs.

Copayments and the Cost of Care

Healthcare in the U.S. is notoriously expensive, and the financial burden on individuals and families continues to grow. Whether it’s rising premiums, out-of-pocket expenses, or copayments, the cost of care has become a key driver of dissatisfaction with the system.

Premiums and Deductibles

Premiums have risen sharply over the last decade, with employer-sponsored plans averaging over $7,000 annually for single coverage and more than $22,000 for family coverage. High deductibles compound the issue, forcing many patients to spend thousands of dollars before insurance coverage fully kicks in.

Copayments and Out-of-Pocket Costs

Copayments—fixed amounts paid for services—add another layer of complexity. For example, visiting a therapist might require a $30 copay, but ongoing mental health treatment could cost hundreds monthly if insurance coverage is limited. These costs are even steeper for out-of-network providers, a common issue for patients under restrictive plans like HMOs.

Rising Drug Prices and Specialty Care

Prescription drugs and specialty care drive significant out-of-pocket spending. Medications for chronic conditions, such as diabetes or cancer, can cost thousands annually, even with insurance. Meanwhile, proposed policies like the BCBS anesthesia cap highlight systemic attempts to reduce costs at the expense of patient care quality, sparking outrage among the public.

Addressing the Costs of Care

Solving the cost crisis requires systemic changes, such as:

1. Policy Reforms: Expanding federal subsidies for ACA plans, limiting copayments, and regulating drug prices.

2. Transparency Initiatives: Giving patients clear, upfront cost estimates for treatments and procedures.

3. Preventive Care Investments: Reducing long-term costs by emphasizing early intervention and wellness programs.

In a system where costs often dictate care decisions, addressing financial barriers is crucial for creating an equitable healthcare model. For many, change cannot come soon enough.

The Role of Public Policy

Public policy is a powerful force in addressing systemic challenges in healthcare. A recent proposal, informally called the "Patients Before Monopolies Act," aims to prevent large healthcare companies from owning pharmacy benefits managers (PBMs) or directly controlling pharmacies. The initiative seeks to curb monopolistic practices that allow insurers to influence drug pricing, limiting competition and raising costs for patients.

Expanding Access to Coverage

Legislation like the Affordable Care Act (ACA) has expanded coverage, but gaps persist, particularly in states that have not adopted Medicaid expansion. Public policy must focus on eliminating these disparities while exploring innovative models to cover uninsured populations.

Regulating Costs and Transparency

The proposed divestiture policy is a response to growing public concern over how PBMs and vertically integrated companies impact drug prices. Critics argue that companies managing both insurance and pharmacy operations have undue influence, prioritizing profits over patients. By mandating separation, the policy could increase competition among drug providers, potentially lowering costs for consumers.

Additionally, measures to require upfront price disclosures for procedures, medications, and insurance premiums can empower patients to make more informed decisions.

Protecting Vulnerable Populations

Policies must prioritize underserved communities, ensuring equitable access to care. Regulations addressing the opioid crisis, mental health funding, and rural health infrastructure are examples of how public investments can directly improve lives.

The Future of Reform

If the "Patients Before Monopolies Act" gains traction, it could redefine how large healthcare corporations operate, creating a more competitive market that benefits patients. Coupled with reforms targeting drug price negotiations, this policy represents a broader effort to balance public health interests against corporate influence.

In an era of growing healthcare distrust, public policy must act decisively to restore faith in the system while prioritizing affordability and access for all.

What Could Drive Change?

Healthcare reform requires collaboration among insurers, policymakers, and healthcare providers. Key areas for improvement include:

• Transparency in Executive Salaries: Increased accountability for leaders like Thompson could drive public trust.

• Streamlined Claims Processes: Reducing administrative hurdles could improve patient outcomes.

• Support for Mental Health: Expanding networks of therapists and reducing copayments for mental health services are critical steps.

Final Thoughts

The U.S. healthcare system faces unprecedented scrutiny as public demand for change intensifies. Will healthcare change? Perhaps—but only with concerted efforts to address controversies, systemic barriers, and patient care gaps.

By navigating trending topics like HMO vs. PPO, Brian Thompson’s leadership, and systemic issues like copayments, we can better understand the complexities of the healthcare industry and advocate for meaningful reform.

The UnitedHealthcare CEO Tragedy: What It Reveals About America’s Healthcare Crisis

A National Shock: The Assassination of Brian Thompson

The tragic assassination of UnitedHealthcare CEO Brian Thompson has become one of the most talked-about events of the year. His death on December 4, 2024, shocked the nation and unveiled deep-seated frustrations with the American healthcare system. Public reaction has been polarizing, with many sympathizing with the suspect rather than condemning the crime.

This event forces us to ask hard questions: What does this tragedy reveal about our healthcare system? Why are frustrations boiling over? And how will the industry respond moving forward?

The Public Outcry and Controversial Perspectives

Public sentiment surrounding the tragedy has been anything but straightforward. The suspect in custody has sparked significant controversy, with widespread speculation about whether the "right person" was apprehended. Social media is awash with conspiracy theories, reflecting the deep mistrust many Americans feel toward corporate healthcare giants.

UnitedHealthcare, as one of the largest insurers in the country, has long been criticized for high premiums, denied claims, and perceived prioritization of profits over patients. These grievances, simmering for years, have now reached a boiling point.

Claims Approvals Surge Post-Tragedy

Interestingly, since Thompson’s death, numerous UnitedHealthcare clients have reported an increase in claims approvals. Procedures that were previously denied are now being greenlit, leading to speculation that the tragedy has prompted temporary changes in claims handling practices.

While we cannot confirm direct causation, the shift raises important questions:

• Were these claims denials unjustified to begin with?

• Is the current scrutiny forcing insurers to reconsider their processes?

• Will these changes remain, or are they a short-term reaction to avoid further backlash?

Controversial Policies Amplify Public Distrust

Even before this tragedy, healthcare companies were under fire for controversial policies that seemed to prioritize cost-cutting over patient care. A prime example is the Blue Cross Blue Shield (BCBS) anesthesia proposal, which sought to limit the amount of anesthesia patients could receive during surgeries.

The proposal was widely criticized as a dangerous attempt to save money at the expense of patient safety. Public outrage led BCBS to pause the policy, but the damage to trust was already done. Incidents like these highlight why so many Americans are deeply skeptical of healthcare corporations.

Implications for the Future of Healthcare

The assassination of a healthcare CEO is an unprecedented event, and its ripple effects will likely shape the industry for years to come. Here are some key takeaways:

1. Increased Scrutiny: Companies like UnitedHealthcare may face heightened public and governmental scrutiny, particularly regarding claims processing and patient care.

2. Policy Reforms: Tragedies often act as catalysts for systemic change. Could this be the moment that spurs comprehensive healthcare reforms?

3. Public Sentiment: The public’s response to the tragedy underscores a need for better communication, transparency, and prioritization of patient welfare.

How This Affects You as a Policyholder

If you’re a UnitedHealthcare client—or a policyholder with any major insurer—this event may impact your experience in several ways:

• Claims Processing: Be vigilant about claims decisions. If you notice changes, document them and advocate for fair treatment.

• Policy Awareness: Understanding your coverage is more critical than ever. Reach out to your insurance agent with any questions or concerns.

• Advocacy: Don’t hesitate to file appeals for denied claims or seek assistance from consumer advocacy groups if needed.

Our Commitment to Clients

At The Baylon Agency, we’re here to help you navigate these turbulent times. We understand the complexities of the healthcare system and are committed to advocating for you. Our services include:

• Claims Support: Assisting with denied claims and appeals processes.

• Policy Reviews: Helping you understand your coverage to make informed decisions.

• Industry Updates: Keeping you informed on changes that affect your healthcare.

Closing Thoughts

The assassination of UnitedHealthcare CEO Brian Thompson is a grim reminder of the tensions underlying the U.S. healthcare system. While the tragedy has sparked important conversations, real change will require collective effort from insurers, policymakers, and the public.

As these events unfold, our agency remains steadfast in supporting our clients. If you have questions or concerns about your coverage, contact us—we’re here to help.

10 Common Health Insurance Mistakes to Avoid During Open Enrollment

10 Common Health Insurance Mistakes to Avoid During Open Enrollment

Open Enrollment is the critical time when you can select or change your health insurance plan for the upcoming year. However, many people make avoidable mistakes that lead to higher costs, inadequate coverage, or unnecessary stress. This guide outlines 10 common health insurance mistakes and offers actionable tips to help you make informed decisions and secure the best plan for your needs.

1. Waiting Until the Last Minute to Enroll

Why It’s a Mistake
Procrastinating often leads to rushed decisions. You might overlook crucial details, miss important deadlines, or fail to gather the necessary documents in time.

How to Avoid It
Start researching and comparing plans as soon as Open Enrollment begins. Use tools like healthcare.gov or consult with an insurance agent for guidance.

2. Choosing the Cheapest Plan Without Considering Coverage

Why It’s a Mistake
Low premiums can be tempting, but these plans often come with high deductibles, limited networks, or minimal benefits that might not meet your needs.

How to Avoid It
Evaluate the total cost of each plan, including premiums, deductibles, co-pays, and out-of-pocket maximums. Consider your medical history, expected healthcare needs, and preferred providers.

3. Failing to Verify Your Doctor Is In-Network

Why It’s a Mistake
Out-of-network visits can lead to significantly higher costs, even with insurance.

How to Avoid It
Check the plan’s provider directory to confirm that your preferred doctors, specialists, and hospitals are in-network. If you’re unsure, call your doctor’s office to verify.

4. Overlooking Prescription Drug Coverage

Why It’s a Mistake
Some plans have limited formularies, meaning they might not cover the medications you need, or they may place them in higher-cost tiers.

How to Avoid It
Review the plan’s formulary to ensure your prescriptions are covered. Look for plans with reasonable co-pays or coinsurance rates for your medications.

5. Skipping Available Subsidies or Financial Assistance

Why It’s a Mistake
Many people qualify for subsidies through the ACA but fail to claim them, resulting in unnecessarily high premiums.

How to Avoid It
Check your eligibility for subsidies at healthcare.gov or consult with an insurance agent. Subsidies can significantly reduce your monthly premium costs.

6. Ignoring the Plan’s Network Size

Why It’s a Mistake
Plans with smaller networks may not include specialists, hospitals, or other providers you need access to, limiting your options for care.

How to Avoid It
Assess whether the plan’s network size meets your healthcare needs. If you have specific specialists or facilities in mind, ensure they’re included in the network.

7. Misunderstanding Health Savings Accounts (HSAs)

Why It’s a Mistake
Many people miss the opportunity to use HSAs effectively, either by not funding them or not understanding their tax benefits.

How to Avoid It
If you’re enrolling in a high-deductible health plan (HDHP), take advantage of an HSA. Contributions are tax-deductible, and funds can be used for qualifying medical expenses.

8. Not Considering Future Healthcare Needs

Why It’s a Mistake
Choosing a plan based solely on your current health status can leave you unprepared for unexpected changes, such as surgeries, pregnancies, or chronic conditions.

How to Avoid It
Anticipate possible changes in your healthcare needs for the upcoming year. Opt for a plan that provides comprehensive coverage and flexibility.

9. Assuming Employer-Sponsored Plans Are Always Best

Why It’s a Mistake
While employer-sponsored plans can be convenient, they may not always offer the best value or coverage for your situation.

How to Avoid It
Compare your employer-sponsored plan with other options available during Open Enrollment. Check if subsidies from the ACA marketplace could make an individual plan more affordable.

10. Forgetting to Reevaluate Your Current Plan

Why It’s a Mistake
Plans and coverage details can change annually. Sticking with the same plan without reviewing updates may lead to unexpected costs or loss of benefits.

How to Avoid It
Take the time to reevaluate your current plan every year. Compare it to other options to ensure it still meets your needs and offers the best value.

How to Make the Most of Open Enrollment

Navigating Open Enrollment doesn’t have to be overwhelming. Here are some additional tips to help you make informed choices:

• Start Early: Give yourself plenty of time to review plans, gather documents, and seek expert advice.

• Consult an Agent: A licensed health insurance agent can provide personalized guidance and help you understand your options.

• Use Online Tools: Many insurance providers and marketplaces offer calculators and comparison tools to simplify decision-making.

• Ask Questions: Don’t hesitate to ask about plan details, coverage, and costs. The more you understand, the better equipped you’ll be to choose wisely.

Conclusion

Open Enrollment is a valuable opportunity to secure the right health insurance plan for your needs, but mistakes can be costly. By avoiding these 10 common pitfalls, you can make smarter decisions and find a plan that fits your family’s healthcare requirements and budget. Take the time to review your options, consult an expert, and ensure your coverage is ready to protect you in the year ahead.

Telehealth Services in Texas: How They’re Changing Healthcare

Telehealth services have gained significant traction, especially in Texas, due to their convenience, efficiency, and ability to expand access to healthcare. Whether you're in a bustling city like Dallas or a rural area, telehealth services make healthcare more accessible. In this blog post, we'll explore how telehealth is changing the face of healthcare in Texas, the common questions surrounding its services, and why it’s an essential part of the future of medical care.

The Rise of Telehealth in Texas

Telehealth—also known as telemedicine—refers to the use of digital communication technologies, like video calls and mobile apps, to provide healthcare services remotely. For Texans, telehealth has been a game-changer. With vast rural regions and sprawling urban areas, many people previously found it difficult to access the care they needed in a timely manner.

The COVID-19 pandemic further accelerated the demand for telehealth services as face-to-face visits were restricted to reduce the spread of the virus. Texans turned to online platforms for consultations, mental health therapy, prescription services, and follow-up appointments. This sudden shift proved the effectiveness of telehealth and solidified its place in healthcare moving forward.

Common Telehealth Services in Texas

Some of the most frequently asked questions about telehealth revolve around the types of services it offers. Let’s dive into the specifics:

• Can Telehealth Prescribe Medication?
  Yes, telehealth doctors can prescribe medication in Texas. However, they typically avoid prescribing controlled substances, such as Adderall or opioids, unless special guidelines are followed. For less restrictive medications, like antibiotics or allergy medications, telehealth professionals can easily assess your condition and send prescriptions to your local pharmacy.

• Can Telehealth Diagnose Conditions like Strep Throat?
  Yes, telehealth providers can diagnose common illnesses, including strep throat, colds, flu, and ear infections, based on your symptoms. In cases where a physical exam is necessary (like throat swabs), you may be referred to an in-person appointment. However, most mild cases can be handled remotely.

• How Telehealth Is Changing Healthcare in Texas
  Telehealth is transforming the healthcare landscape by improving patient outcomes and offering a more accessible, affordable alternative to in-person visits. For Texans who live far from medical facilities, telehealth provides a lifeline, offering quicker access to specialists and cutting down on travel expenses.

Benefits of Telehealth for Texans

Texas, with its large rural population, faces unique challenges in healthcare delivery. Telehealth addresses these challenges by offering a range of benefits:

• Improved Access
  In rural regions where healthcare facilities might be hours away, telehealth bridges the gap by providing direct access to specialists and general practitioners. No more long drives to appointments—just open your computer or smartphone and connect with your healthcare provider from the comfort of your home.

• Time and Cost Savings
  With telehealth, there’s no need to take a day off work or spend money on transportation. By reducing the need for in-person visits, telehealth allows patients to save on costs, which can be crucial for those without comprehensive insurance coverage. It also reduces the burden on hospitals, allowing them to focus on critical in-person care.

• Mental Health Services
  Telehealth has been especially valuable for Texans seeking mental health services. Online therapy and counseling sessions have surged, offering a discreet, comfortable environment for individuals needing help with stress, anxiety, depression, and other behavioral health issues. Providers like United Healthcare’s Mental Health Complete Plus offer teletherapy options that can be accessed from anywhere in the state.

The Future of Telehealth in Texas

Telehealth is not just a temporary solution; it's becoming a permanent feature of Texas' healthcare system. Many healthcare providers and insurers have expanded their telehealth services to meet the growing demand. Moving forward, telehealth is expected to play an even bigger role in managing chronic illnesses, post-operative care, and long-term treatment plans.

This trend is evident in policies that support telehealth services. Many health insurers, including United Healthcare, now offer telehealth as part of their comprehensive plans. If you’re looking for telehealth coverage in Texas, companies like United Healthcare provide access to telehealth options through programs such as Healthiest You, New Benefits, and Mental Health Complete Plus.

Where to Get Telehealth Services in Texas

If you’re searching for telehealth services in Texas, several platforms can help you access high-quality care, including teletherapy, general healthcare, and specialty consultations. Providers such as United Healthcare offer telehealth services through their online portal. You can explore options like Healthiest You, New Benefits, and Mental Health Complete Plus to receive care from licensed professionals in a wide range of specialties.

For more details on telehealth plans, visit the United Healthcare portal below:

Conclusion: Telehealth Is Here to Stay

Telehealth has already proven its worth in Texas, from managing mental health to providing routine medical care. As we move forward, telehealth will only grow, offering more flexibility and access to healthcare for Texans everywhere. Whether you’re seeking a diagnosis, prescription, or counseling, telehealth can provide the care you need from the comfort of home.

For more information on health and telehealth plans in Texas, feel free to explore our range of options on The Baylon Agency’s website or contact us for personalized guidance on how to incorporate telehealth services into your healthcare plan.

10 Essential Questions to Ask Before Choosing a Health Insurance Plan

Choosing the right health insurance plan can feel overwhelming, but by asking the right questions, you can find a plan that meets your health needs and fits your budget. To help you make an informed decision, we’ve compiled a list of the most important questions to ask before selecting a health plan.

1. What Does the Plan Cover?

Health insurance plans are required to cover certain essential health benefits, but the details of what’s included can vary significantly. You’ll want to check that the plan covers:

• Doctor and specialist visits

• Hospital care, including surgeries and emergency services

• Preventive care, like vaccines, annual physicals, and cancer screenings

• Prescription medications

• Maternity and newborn care

• Mental health services and substance use treatment

If you have specific medical needs, such as regular therapy sessions, long-term prescriptions, or planned surgeries, make sure the plan covers these services without excessive restrictions. Understanding exactly what the plan covers will prevent surprises later when you need care.

2. What Are the Total Costs?

When comparing plans, it’s easy to focus on the monthly premium. However, that’s only part of the cost. Be sure to evaluate the following:

• Premium: This is the amount you’ll pay each month to keep your coverage active.

• Deductible: The amount you need to pay out-of-pocket each year before the insurance company starts covering your medical expenses.

• Copays and Coinsurance: Even after your deductible is met, you’ll likely pay a portion of the costs for doctor visits, prescriptions, and other services.

• Out-of-Pocket Maximum: This is the most you’ll have to pay in a year for covered services. Once you reach this limit, the insurance company will cover 100% of your medical costs for the remainder of the year.

It's essential to find a balance between the premium and the out-of-pocket costs. For example, a lower premium might seem attractive, but if the deductible is too high, it may not be affordable when you actually need care. Make sure to calculate what you’ll likely spend annually on healthcare to choose the best plan for your budget.

3. Are My Preferred Doctors in the Plan’s Network?

Health plans usually work with a network of doctors, hospitals, and healthcare providers. If you have doctors you trust or want to continue seeing, confirm they’re part of the plan’s network.
Going outside the network may result in higher out-of-pocket costs or no coverage at all, depending on the plan. For instance, some plans like HMOs (Health Maintenance Organizations) may not cover out-of-network providers at all, while PPOs (Preferred Provider Organizations) typically cover a portion of the costs.
It’s worth checking the network size and the reputation of healthcare providers in the network, especially if you’re considering switching doctors.

4. Are My Prescription Medications Covered?

Prescription drug coverage can vary widely between health insurance plans. Some plans have a formulary, or list of covered drugs, that may include your medications but at different tiers. Medications in higher tiers usually come with higher copays or coinsurance.
Be sure to check:

• If your specific medications are covered.

• What copays or coinsurance you’ll be responsible for.

• Whether the plan requires you to try cheaper medications (step therapy) before covering your prescription.

If you rely on regular medications, understanding the prescription drug coverage is crucial to avoid unexpected costs.

5. Can I See a Specialist or Out-of-Network Provider?

If you need specialized care, you should confirm whether the plan requires a referral from your primary care physician before you can see a specialist. Some plans, like HMOs, require referrals, while others, such as PPOs, allow you to see specialists without one.

Additionally, it’s important to know how the plan handles out-of-network care. While most plans cover emergency care regardless of the provider, non-emergency out-of-network visits could come with much higher costs—or may not be covered at all. If you prefer flexibility in choosing doctors, a PPO or POS (Point of Service) plan might be a better fit, as these plans tend to offer more freedom to see out-of-network providers.

6. What Is the Process for Referrals and Prior Authorizations?

Some health insurance plans require referrals or prior authorizations for certain treatments or specialists. This means your primary care physician must approve your visit to a specialist, or the insurance company must authorize a procedure before it’s covered.

Understanding the rules for referrals and prior authorizations can help prevent delays in your care. Be sure to ask how easy it is to get these approvals and whether they typically lead to any delays in treatment.

7. Are There Wellness Programs or Additional Benefits?

Many health insurance plans offer additional benefits to support your overall well-being. These might include:

• Gym membership discounts

• Wellness programs, like smoking cessation or weight-loss counseling

• Access to telehealth services

• Discounts on dental or vision care

These extras can add real value to your insurance, especially if you’re looking to maintain or improve your health. Be sure to explore whether the plans you’re considering offer any of these added benefits.

8. How Is the Plan Rated for Customer Satisfaction?

It’s important to check how other customers have rated the health insurance plan in terms of satisfaction. Factors to look for include:

• How quickly and easily claims are processed

• The quality of customer service and support

• How well the plan handles disputes or issues

• Overall satisfaction with the coverage provided

A plan may look great on paper, but if it’s known for poor customer service or slow claims processing, it could lead to frustration when you need help the most. Many insurance review websites and resources can give you insight into a plan’s performance.

9. What Happens If I Need Care While Traveling?

If you travel frequently, either domestically or internationally, you’ll want to know how the plan handles care outside your local area. Most plans cover emergency services anywhere, but non-emergency care might not be covered outside of your network.
Ask if the plan offers nationwide or international coverage, especially if you travel for work or pleasure. This can help ensure you’re protected no matter where you are.

10. Are There Penalties or Fees for Canceling the Plan?

Before committing to a health insurance plan, ask about the terms and conditions if you need to cancel or switch plans. While there may be no penalties for canceling during the open enrollment period, leaving a plan outside of that window could come with fees or restrictions.
It’s important to fully understand the cancellation policies, especially if you anticipate any changes in your health or employment situation that could require you to switch coverage mid-year.

Choosing the right health insurance plan doesn’t have to be complicated when you know what questions to ask. By understanding the coverage, costs, and flexibility of each plan, you can confidently make a decision that suits your needs.

Need help reviewing your current policy or comparing new options? We offer a free policy review to help you find the best coverage for your situation. Contact us today to schedule your review!