All health insurance plans have a predetermined list of services that they will partially or fully pay for (covered services).

Find out whether a potential new plan covers known medical expenses for you or your family members. These include monthly prescription drugs, ongoing visits for a chronic condition, home medical equipment, behavioral health needs and planned surgical procedures.

You know your budget better than anyone. So, look carefully at a plan’s monthly premiums, annual deductibles, co-pays and co-insurance fees. You want to make sure that you won’t have to pay for a high deductible or other out-of-pocket expenses you can’t afford if the unexpected happens.

For many people, one of the biggest health insurance decisions is whether to enroll in an HMO or PPO. Both types of plans use a network of contracted providers and facilities. But there are differences in how you can use that network.

In most HMOs, you select a primary care provider (PCP) who coordinates all your care, including referrals for specialist visits and certain procedures.

With most PPOs, you can self-refer for specialty care; there are fewer restrictions on who you can see. Generally speaking, the flexibility of a PPO comes with a higher monthly premium.

Health insurance companies work with different doctors and clinics to help you get the best deals on your care.

Getting care from a person or place your plan covers saves you money. On the other hand, getting care somewhere else may mean your health plan pays less, leaving you with bigger bills. That’s why you’ll want to check that the doctors and clinics you expect to visit will be covered by the health insurance plan you’re considering.

Imagine that, under the plan you’re considering, you and your family have a good health year: You go to the doctor a few times for checkups, your partner takes a couple prescriptions, the kids visit urgent care a couple times – and that’s about it.

If you don’t expect to use your plan that often, pay close attention to recurring costs to see if there’s an opportunity to save money. But remember: It’s impossible to fully plan for the unexpected, so be sure to also factor in the cost of getting care if (and when) you need it.

Sometimes it’s expected and sometimes it’s not – but life changes, and so does what you need from your health plan.

If you know how your plan can grow with you, it’s easier to make a decision you’re comfortable with from the start. That way, you’ll have a good understanding of how different changes will affect your and your family’s coverage.

Health plans have drug lists (also called formularies) of the prescription medicines that they cover. Your benefit summary will show how much you will pay for drugs in different “tiers” on the drug list. Many plans also have a way for you to price a specific drug and can help you sign up for home delivery.

• Check to see if the plan covers emergency services outside of its normal service area.
• See if it offers telemedicine services. Telehealth, or virtual visits, let you use your phone, mobile device or a computer to consult a doctor from almost anywhere you are.
• Find out where you can look up urgent care centers if you’re away from home and suddenly get sick.

Some may include or offer, at an added charge, dental coverage for preventive services (such as cleanings) and comprehensive services (such as fillings and crowns). Some medical plans, by law, include pediatric (children’s) dental coverage.

If you ever need to file an insurance claim, do you know what your out-of-pocket cost will be? Ask an agent about your deductible and ensure it works within your financial situation.

That’s the most you’d have to pay towards your covered medical expenses.