Managed Care
Comparing Health Plans
Questions to Ask When Comparing Health Care Plans:
Cost:
How much will I pay for monthly premiums?
How much are co-payments for office visits?
How much are co-payments for prescriptions?
What services are limited and not covered?
Are there penalties if I change health care plans?
Access to Care:
Can I keep my family doctor or nurse practitioner?
Are nurse practitioners/nurse anesthetists available in the plan?
Are certified nurse midwives available?
How are referrals handled?
Are children who are out of state covered?
How am I covered if I travel out of state?
Benefits:
What must I do to get care?
What are the waiting times for appointments?
How quickly can I expect to be seen for illness or for routine care?
Are second doctor's opinions covered?
Is preventive care covered, i.e. immunizations?
Are pre-existing conditions covered?
Are hospitalizations and surgeries covered?
Are outpatient surgeries and other outpatient services covered?
Are prenatal care and delivery covered?
Is emergency care covered outside of the area?
Quality of Care:
How do I find out about quality?
Does the plan have an up-to-date "report card"?
Consumer Guide
to Michigan's Health Maintenance Organizations (HMOs)
Consumer Guide
to Michigan Preferred Provider Organizations (PPOs)
The Michigan Bill of Rights:
You are guaranteed the following rights as a health-insurance consumer:
Information about your insurance plan.
Health coverage sooner for problems that existed before you enrolled
in your health plan.
Faster and clearer ways of handling complaints.
Contact the Office of Financial and Insurance Services
for more information about your rights.
Phone #: 517-373-3460, 517-373-0240
Fax: 517-335-0908
State of Michigan's Office
of Financial and Insurance Services (OFIS)
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