Questions to Ask your Health Insurance Company

Use these questions below as a guide when you talk with your insurance company before receiving care — or when selecting a health insurance plan. Be sure to note the name of the person you speak with and the date of your conversation.

Information you may need to provide about Roswell Park:

Questions to ask

• What type of insurance plan do I have?
• Is Roswell Park Comprehensive Cancer Center considered in-network for my health plan?

If yes, here are some follow-up questions to ask:

• Does my insurance plan cover physician costs, as well as inpatient and outpatient hospital services?
• Does my insurance plan cover prescription medications and chemotherapy medications?
• What percentage of my bill does my insurance cover? What am I required to pay?
• What, if any, are my co-payments and/or deductible amounts?
• Have I met my out-of-pocket requirements?
• How much is remaining for the fiscal/calendar year?

If no, and Roswell Park Comprehensive Cancer Center is not in your provider network, you need to ask:

• Does my plan offer access to Roswell Park Comprehensive Cancer Center through a national rental network?
• Does my plan have out-of-network benefits?  If so,
  • If I choose to go out-of-network, what percentage of my bill will be paid by the insurance company?
  • What do I have to pay?
• Does my insurance plan offer any additional coverage through special networks for treating medical conditions such as cancer?
• Does my policy have an out-of-pocket maximum? If so, ask:
  • If my out-of-pocket expenses reach the maximum, will the insurance carrier ever reimburse at 100%?
    • If so, does this mean that my claims will then be paid in full, or will I still be responsible for the difference?
• Before I see a doctor at Roswell Park Comprehensive Cancer Center, do I need a referral from my primary care physician? Will I need an authorization from my insurance carrier?
• Will I be covered for any testing, pathology, or radiology charges that may be incurred as part of my initial consultation with a Roswell Park doctor?