Insurance Police Paper

Waldorf University Insurance Police Paper

Q1- What is the plan year for you policy (effective dates)?

Q2- Is your plan an HMO, PPO, Traditional indemnity or other type of plan? How do you know this? Where did you find this information?-

 Q3- Define the term “co-pay.” Where does a co-pay apply within your coverage? How much does co-pay impact your decision to access healthcare?

 Q4- Define the term “deductible.” In dollars, what is the deductible in your policy?

Q5- Define the term “co-insurance.” Where does co-insurance apply within your coverage? How does co-insurance differ from co-pay

Q6- Are you required to identify a Primary Care Physician (PCP) when you enroll? Do you have a PCP? How did you choose your PCP? If you do not have a PCP– why not?

 Q7- Where does pre-certification or pre-authorization apply within your coverage? How does this requirement impact your decision to access healthcare?

 Q8- Describe the use of a formulary when a policy has pharmacy benefits. Does your coverage provide a forumlary?

 Q9- What, if any, wellness benefits are covered in your plan? Do you access them?

Q10- What is meant when a policy has “out of network” stipulations. Does this impact your decision to access out of network healthcare?  

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