Questions to ask when comparing health plans
What does the plan pay for and what does it exclude?
Look for benefits such as:
- Preventive care
- Well-baby care
- Substance abuse
- Organ transplants
- Maternity care
- Chiropractic care
- Naturopathic care
- Mental health care
Find out how the plan works
- Do you have a copay?
- How much is the deductible?
- How often will you have to pay the copayments or deductibles (per year, per occurrence)?
- Are there limits on the number of times you can receive a service (lifetime maximums, daily, or annual benefit caps)?
- Does the plan cover prescriptions?
- Are your prescriptions on the list of covered drugs (this is generally called the "formulary" list)?
- Can you see your provider?
Ask if there are special requirements to get your care covered
- Do you need prior authorization for some services? If so, how do you get authorization?
- Are there waiting periods before coverage takes effect?
- Are some types of care excluded?
To help you compare plans, use our Plan comparison form (PDF, 163KB)