Health Insurance

  1. What to Ask when Shopping for Health Insurance
  2. Phone and Online Solicitations
  3. Plan-Specific Questions
Getting the right information can help you choose the right health insurance for you and your family.
Here are some questions to ask yourself before you start to look for insurance and some questions to ask anyone who offers you coverage.  

We all know health insurance can be complicated. There are differences in what is covered and what you will have to pay out of pocket. 

With so many options and information out there, it makes it even more difficult to sort through when you get solicited for health insurance online or by phone. Scammers like the anonymity of telemarketing and take advantage of that confusion. Check out Phone and Online Solicitations section above. This section offers some simple questions you can ask so that you are not taken advantage of by a scammer.   

If you need help to understand health insurance, you can visit with a licensed insurance agent or a navigator. You can find definitions of health insurance terms on, the Federal Marketplace for health insurance. If you’re a senior, you can contact the South Carolina Department on Aging or call 1-800-MEDICARE to talk to someone about health insurance for seniors. 

      Questions to ask yourself

                   Why it’s important

 Why do you need health   insurance?

 Life is full of surprises. Insurance helps   you prepare for the unexpected, like an   accident or an illness. A single trip to an   emergency room can lead to a bill of   thousands of dollars.

 Is the plan with the lowest   premium really the most   affordable?

 Plans with lower premiums often   have more limited benefits. You   should consider not only the cost   of premiums, but also how much   you’ll pay out-of- pocket when you   need health care.

 Who are you buying health   insurance for?

 You might need coverage just for   yourself, just for a family member, or for   the whole family.

 How long do you need health   insurance – a full year or for a   few months?

 Some plans might be limited to a few   months. Others will cover you for an   entire year and then that coverage can   be renewed.

 Do you have a known health   condition (a pre-existing   condition)?

 Even if you look and feel healthy, you   may not be getting the routine care   necessary to identify the unexpected.   Thinking about your family health   history, your current health conditions,   prescription drugs you may need, and   the health services you need will help   you understand the coverage you want.   But remember, accidents and   unexpected illnesses happen, so you   might need services you don’t expect.

 Many plans cover services to treat       pre-existing conditions, but some don’t.

 What prescription drugs do you   need?

 Do you have any chronic health   conditions, like high blood   pressure, diabetes or an   autoimmune disorder? Even if   you haven’t been to a doctor,   are you in pain or   having problems you believe   will result in any health care   services or treatment?

 Do you have a family doctor or   hospital?

 You’ll pay less to see providers that   accept your health insurance – which   may not include your family doctor or   hospital. The terms to know are           “in-network’, “tiered network”,                 “non-participating” and “out of   network.” Many plans pay more of the   costs for services you get from doctors   or facilities in the plan’s network.

 Are you ready to pay the   full cost for services until a   deductible is reached?

 The deductible is the amount you pay   before your insurance company starts   paying their share of the cost of care.   Even with insurance, you pay the full   cost of services until you meet your   plan’s deductible.

 Are you able to pay the full cost   for services if the plan limits how   much it will pay?

 Some plans only pay up to a certain   dollar amount; you may have to pay the   cost beyond that amount.