• Will I be able to use my doctors? Are they in the plan's network and are they taking new patients who have this plan?
• Do my doctors recommend joining this plan?
• Which specialists, hospitals, home health agencies and skilled nursing facilities are in the plan's network?

Access to Health Care

• Who can I choose as my Primary Care Physician (PCP)?
• Does my doctor need to get approval from the plan to admit me to a hospital?
• DoI need a referral from my PCP to see a specialist?

Benefits

• What extra benefits does the plan offer? What rules do I have to follow to get them?
• Physical exams
• Dental services
• Vision care
• Hearing aids
To learn more about Medicare drug coverage (which is often offered by Medicare private health plans), click on the link in the GO TO box.
• Are my prescription drugs on the plan's formulary (list of covered drugs)?
• Does the plan require that I get “prior authorization” before my prescription will be covered, or impose other restrictions (like limiting the quantity or requiring that I try a cheaper medication before it will cover a more expensive one)?

Cost

• How much is my monthly premium?
• How much will I have to pay out of pocket before coverage starts (what is the deductible)?
• How much is my copayment for a visit with my PCP or a visit with a specialist?
• How much will I pay for brand-name drugs? How much for generic drugs?
• How much will I pay if I use a non-network doctor or hospital?
• Are there higher copays for certain types of care, such as hospital stays or cancer treatment?
• Is there an annual out-of-pocket maximum? (After you spend a certain amount will your care be free or very low-cost?) Are all services included in the out-of-pocket maximum?

Service Area

• What service area does the plan cover?
• What kind of coverage do I have if I travel outside of the service area?