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Insurance Primer


Here are some of the questions you might want to ask your agent or the health insurance company when making your decision: 

  • How do I choose a doctor, and can I change doctors?
  • Do I have to use specific doctors or hospitals?  If so, is my doctor part of the plan's provider network?
  • What happens if I don't use a doctor or hospital on the network list?
  • What happens if my doctor leaves the plan's network?
  • How do I obtain prescription medications?
  • How does the company bill for premiums, and how do I want to pay?  Do I have any options in how I pay my premiums (e.g., monthly, quarterly or semiannually; by check or bank withdrawal)?
  • Can I enroll directly with the company or does an intermediary or association have to process my paperwork?  Are there any additional costs for enrolling through associations or intermediaries?
  • If I pay in advance and later decide to cancel my coverage, am I entitled to a refund of any advance payment?  How would the refund be calculated?
  • Do I have to file claims?  If so, how is it done?
  • If I have to file a claim, how long does it take to process the paperwork? 
  • What is the procedure if I have a complaint?
  • Is there a local office to help me with questions or problems?
     ... from the Massachusetts Division of Insurance