There are many things to consider when choosing a plan. Ask yourself the following questions to guide your decision. Then take a quiz to see which Blue Cross plans fit you best.
If you're between jobs or looking for a job, you may want to consider short-term coverage. But if you’re self-employed or your employer does not offer group health insurance coverage, you may need longer term coverage offered through an individual and family health insurance plan. If you’re not currently covered, consider short-term coverage while you wait for a longer-term plan to become effective. (Short-term plans do not cover preexisting conditions.)
Some insurance plans offer basic coverage that protects your finances in case of a major illness or injury. These plans typically have a lower monthly premium, but you’ll be responsible for more of your health care costs each year. (Some basic plans, like Simply Blue, cover preventive care and generic drugs.)
Other plans offer more comprehensive coverage that may include chemical dependency or behavioral health care, maternity, prescription drug benefits, vision and eye care, and regular doctor office visits. These plans typically have a higher monthly premium and may be appropriate for people who intend to use their insurance on a regular basis.
Check the plan’s provider directory to verify that your doctors and hospitals are included in the plan’s network. You receive the highest level of benefits if you use doctors in the plan’s network.
Under some health insurance plans, you need a referral from a primary care doctor to see a specialist. With Blue Cross and Blue Shield of Minnesota plans, you don’t need a referral to see a network specialist.
Some plans have provider networks that are based on where you live. If you travel outside that area, you are not covered by your health plan. Blue Cross plans include access to the BlueCard® and BlueCard Worldwide® networks, so you’re covered almost anywhere in the United States or the world.
Are you planning to become pregnant? Some plans, like Simply Blue, for example, do not cover labor and delivery. If you're planning a family, you may want to consider plans that include coverage for maternity labor and delivery, like Personal Blue.
You may also wish to pay attention to a plan’s coverage for things like mental health and substance abuse care. With some plans, for example, you can opt out of substance abuse coverage.
If you need coverage for your family, now or in the future, be sure that you are purchasing family coverage, and not single-only coverage just for you. See plans for families.
Most individual health plans do not cover the cost of care for a preexisting condition — a condition you have had during a period prior to your enrollment date in the plan. Generally, those conditions are not covered until you have been a member of the new plan for a certain number of months. As of September 23, 2010, you can include a dependent under age 19 on your plan without exclusions for preexisting conditions, and Blue Cross will pay for claims for those conditions without a waiting period.
Some plans, such as Options Blue, work with health savings accounts that can be used to pay for care. See more benefits of a plan with a health savings account.
Prescription drug coverage varies by plan. For example, some Blue Cross plans require that you pay a copay, depending on the type of drug purchased. Blue Cross pays the balance. On other plans, such as Options Blue, you must first meet your deductible before anything is paid. With Simply Blue and most Personal Blue plans, generic drugs are covered by the plan at 100 percent after you pay a $5 copay.
Most plans have a formulary, or list of drugs, that the plan covers. Check if your drug is covered with a Blue Cross individual plan.
Does the plan have tools & resources to support decision making and my health?
Does the plan offer a wide range of tools and resources to help you stay healthy – so you pay less in medical costs? Does it offer services like a nurse line – a 24-hour line you can call to find out the best course of action when you or your child gets sick after hours? Does it offer resources to help you compare costs and quality of doctors and hospitals, so you can choose the right one? Blue Cross has health support like its health club discounts, Stop-Smoking Support, Weight Watchers discounts and more to help you and your family be your healthiest and keep medical costs down.
What is the health insurance company’s reputation?
Find out about the company offering the health plan. How long have they been in business? Have they been rated by independent agencies with regard to their financial strength? How do their ratings compare to the ratings of companies offering other plans? Blue Cross has an A.M. Best rating of “A-” (Excellent).
What about customer service? Are they known for quick and hassle-free claims payments?
Consider your options carefully
Ultimately, you want a plan that meets your needs for types of coverage, access and dependability — all at a reasonable cost. You’ll get to that conclusion by understanding your options and carefully considering your alternatives.
Use our Plan Selector for help choosing a Blue Cross plan.