How To Compare Individual Health Insurance Plans? 
Very carefully . Shopping for health insurance has never been particularly easy for the average person and with the implementation of the Affordable Care Act it is more complicated than ever and the consequences of making a bad decision or no decision can have significant financial implications . Web sites , whether they are Healthcare.gov or insurance agent or insurance carrier based can only go so far . Buying health insurance is n't like buying a hotel room online , as a lot of people who enrolled themselves through Healthcare.gov have painfully learned . The bottom line is that you should seek out an experienced health insurance agent who represents multiple health insurance carriers and who is certified to sell coverage through Healthcare.gov or your state 's health insurance marketplace . You can no longer assume that your doctor is available as an in-network provider with every health insurance plan offered by a health insurance company that you think you are familiar with . For instance , here in Tennessee the Blue Cross/Blue Shield plan offers identical looking health plans through Healthcare.gov with three different PPO networks each of which has a different price point . The lower the monthly premium gets the narrower the provider network gets . Human nature is to gravitate towards the lowest cost plan if the benefits look the same and that 's fine until you find out your long time doctor does n't participate in that product 's network . In the world of ObamaCare once you 've enrolled and the open enrollment period has closed you are stuck with your plan selection until next year 's open enrollment . If you are using specific prescription medications you really need to do your homework there and that 's where having professional guidance is so crucial . You should verify if your medication is covered in the prescription formulary of any health insurance carrier you are considering . Then , if it is covered , at what tier level in the pharmacy coverage is it covered ? Will the insurance carrier require you to get reauthorized to continue using that medication or require you to reinvent the wheel and go through what is referred to as step therapy where you may have to try to use other , less expensive medications to treat your condition before you are allowed to continue using your current medication ? These are all real possibilities and I have n't come across an individual consumer yet who figured these things out on their own . What coverage does the insurance plan you are considering offer if you want to go outside of their network ? Some health insurance brands you may have been familiar with in the past have totally reworked their individual insurance products so as to provide little or no out-of-network coverage . What is the health insurance plan 's policy on access to facilities such as M.D. Anderson , the Mayo Clinic and other such nationally prominent specialty health care providers ? You should not assume that all health plans will allow access to such facilities . If you have a chronic health problem or have had a family history of health issues where access to such facilities might be important to you , it 's better to figure that out in advance . THIS ANSWER WAS PROVIDED BY : Marlin McKelvy , a Chartered Benefits Consultant with 30 years of industry experience and a web site at www.cdbsagency.com but who is committed to providing personalized advice and guidance because an informed client is a happy client . 