If you are taking an expensive medicine for a chronic condition - and you change health plans - a new plan may require you to try another medicine before they will pay for the one you are currently using. Or, the new plan may not cover the medication, or require documentation from you or your clinician’s office explaining why you need to continue the medicine you’ve been taking.
Similarly, if you are seeing a specialty clinician , a new health plan might not include them as “in-network” providers, which would mean the new plan would not pay for care from their office, or you could have to pay more than your current plan. Also, some new plans may have higher co-insurance percentages for seeing your specialists – something else to be aware of when considering new health plans.
Almost all insurance has a limit on what you are required to pay in a year for health care services. This “out-of-pocket cap” in 2020 will be no more than $8,150 for individual coverage and $16,300 for family plans that meet ACA requirements.for health plans that offer very low premiums.
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