ARE YOU CONSIDERING CHANGING YOUR HEALTH INSURANCE PLAN? 

When considering a change to your commercial health insurance plan, be sure to ask the following important questions to help you decide which plan is right for you: 

If you are currently enrolled in a Hemophilia Treatment Center (HTC), you may want to contact your HTC to identify additional programs and/or resources that may be available to you. 

 

GENERAL COVERAGE QUESTIONS TO ASK WHEN CONSIDERING A NEW HEALTH INSURANCE PLAN: 

  1.  What is the monthly / annual premium for the plan?  

  2. What is the total of out-of-pocket costs, including medical and prescription co-pays, 

    deductibles and co-insurances? 

  3. Does the plan cover all the services you need?  (Define those services for yourself.) 

  4. Check to be sure your physicians are in the plan’s provider network. 

  5. Are there annual limits?  If so, is it a maximum annual benefit limit based on dollars or on 

    number of visits?  For example, mental health coverage is usually limited to a certain 

    number of visits per year. 

  6. Are out-of-network benefits available?  Are you covered if you get sick out-of-state? 

COVERAGE RELATED TO BLEEDING DISORDER CARE / MEDICATIONS: 

  1. Are all FDA approved medications for bleeding disorders covered under the plan? 

  2. Do I have a choice of more than one pharmacy provider? 

  3. Is my Hemophilia Treatment Center (HTC) in the plan’s provider network? 

  4. Is durable medical equipment covered? 

  5. Do I need a referral to see a specialist? 

  6. What services require prior authorizations? 

 

For further information, view the National Bleeding Disorders Foundation’s personal health insurance toolkit or call NHF directly at 1-800-424-2634.