5 Steps to Choosing the Right Health Plan

1. Names of preferred doctors and hospitals nearby. Check that the doctors you see are in the health plan’s network. For WHA members, you can search our Provider Directory. You can also search for specialists and hospitals. Keep in mind, WHA’s network includes approximately 3,000 doctors from multiple medical groups.
    
2. Review this year’s health care expenses. If you are a WHA member, use your Accumulator from this year’s WHA plan to review and compare coverage between plans. See if you met your deductible (and how quickly and why), or what copays and coinsurance factored in. When you do, you can see where the essentials in the plan work toward anticipated spending for next year.
    
3. Anticipated health needs. Look ahead the upcoming year to see if you are planning any procedures, such as knee surgery, or pregnancy and childbirth. Look for a plan that offers comprehensive coverage for the areas where you’ll need it most, while still keeping your premiums affordable. High deductible plans will be lower in monthly premium but require higher spending at the time of service; copay plans will be higher in monthly premium but require a lower copay at the time of service. Check out our Service Cost Estimator to determine what your costs would be on a deductible plan.
    
4. Gather your medications. Check to see the prescriptions you need are covered. Search using WHA’s Preferred Drug List to see costs/coverage.
    
5. Getting care. Finally, look for coverage on how you want to get care, for example, if you are enjoying telehealth choices this year, look to ensure your plan has virtual care coverage, or if you want to quit smoking, check to see if your plan has a free smoking cessation program. There are many wellness programs built into WHA plans, so check to see what's available at no added cost and factor that into your overall health coverage and care.

If you think you’ll qualify for financial assistance to help pay for your monthly premium, our member services team at 916.563.2250 can help you with the process. Or if you prefer, you can visit CoveredCA.com and select “Shop and Compare” for options.  It’s important to know last year’s household income (your 1040 tax form helps). Both federal and state premium assistance is available so you may be eligible even if you didn’t qualify in the past.

We’re here to help. Individuals can go to chooseWHA.com or call us at: 916.563.2250.

If you qualify for Medicare plans this year, go to medicare.westernhealth.com