As you get ready to buy health care coverage, here are a few things to think about before you decide on a plan that works for you and your family.
Do You Qualify for Assistance or Special Enrollment?
Whether you’re buying for the first time or renewing the coverage you have, check to see if you qualify for help paying your monthly premium or your share of the cost for services. The rules may change from time to time.
You may need your tax records from the last year to show your income. If you are enrolling outside open enrollment, you will also need valid proof of the life event that qualifies you for Período especial de inscripción.
Do You Have a Doctor You Like?
If you already have providers you like and will still want to see, make sure they’re in the network for the plans you’re interested in. To check, ingresar to your online account and go to Find Care.
¿Qué afecta cuánto gasta?
Los costos de la cobertura de atención médica incluyen lo siguiente:
- Monthly premium: Generally, the higher the monthly premium, the more the plan pays for covered services. This may be important if you have a chronic condition, plan to have a child, or expect to have higher health care costs.
- Deductible: A deductible is the amount you pay out of pocket before the plan pays. Las coberturas con deducibles más altos pueden tener una prima mensual más baja. Recuerde que debe cumplir con el deducible de la cobertura antes de que el plan comience a pagar los beneficios.
- Cost sharing: These include out-of-pocket payments such as copays and coinsurance.
What’s Coming Up? Or Might Be Coming?
No podemos predecir el futuro. Illnesses, injuries and other unexpected events can happen, but you can plan ahead.
- If you have a family history of a chronic condition or conditions, you may want to consider a plan with lower copays for doctor and specialist visits and tests.
- Some sports may raise your risk of getting hurt. You may want to look at plans with a lower deductible if an extended stretch of treatments may come up.
- Consider your mental health as well as your physical health. Therapist visits for stress or mental health conditions may require copays as well.
What Medicines Do You Take?
Prescription drug coverage and copays or coinsurance amounts vary between plans.
All health plans we provide have a list of drugs the plan covers. The list includes payment level tiers. Drugs in a lower tier usually cost less.
If any of your covered drugs moves to a higher tier with a higher out-of-pocket cost, ask your doctor if there are lower tier alternatives or generics available.
Por lo general, un genérico actúa como un medicamento de marca con la misma dosis, fuerza y administración. Los medicamentos genéricos también están aprobados por la Administración de Alimentos y Medicamentos.
Is a Health Savings Account Right for You?*
Some plans work with an HSA, which is a special savings account you can use to cover a wide range of qualified health care expenses. An HSA can help you take charge of your health and how you spend your health care dollars. Not all plans are HSA compatible, so be sure to review your options.
Please note: Some people with cost-sharing reductions under their benefit plan that reduce the deductible below the federal government's minimum deductible may not be eligible to contribute to a Health Savings Account. Consulte con su asesor fiscal para obtener más información.
Uno de nuestros agentes de ventas autorizados o su agente independiente y autorizado de Blue Cross and Blue Shield of Illinois puede ayudarlo a entender sus opciones.
*Las Cuentas de Ahorros para la Salud (HSA, en inglés) tienen repercusiones fiscales y legales. Blue Cross and Blue Shield of Illinois no proporciona asesoramiento en materia legal ni fiscal, y nada de lo aquí expresado debería interpretarse como tal. Ni este material ni ninguna de las declaraciones fiscales incluidas en el presente están destinados ni redactados para evitar sanciones fiscales, ni pueden usarse ni considerarse para tales fines. Si hay declaraciones relacionadas con impuestos, pueden haber sido redactadas en conexión con la promoción o la comercialización de las transacciones o los asuntos tratados en este material. Usted, en función de sus circunstancias particulares, deberá consultar a un asesor fiscal independiente acerca de las consecuencias fiscales de las coberturas o los seguros de gastos médicos específicos.
Fuente: , Administración de Alimentos y Medicamentos de los EE. UU., 2025