Health Plan Comparison Form (Page 3 of 4) in pdf

Health Plan Comparison Form Page 3

Coverage (continued)

Are there limits on the number of visits

Yes

for types of care?

Other considerations

If I travel, does this plan cover care outside

Yes

my local area?

Does this plan coordinate benefits with

Yes

other health plans?

Is this insurance plan authorized to do

business in Washington state? (To find

out, go to:

Yes

consumertoolkit/search.aspx or call the

Insurance Consumer Hotline at 1-800-

562-6900)

Does the company have a high number of

consumer complaints? (To find out, go to

https://fortress.wa.gov/oic/complaints/ or

Yes

call the Insurance Consumer Hotline at

1-800-562-6900)

*For Medicare clients only

Yes

Is the plan’s drug coverage as good as

N/A - Plan is Part D or

Medicare Part D?

(Check one)

Medicare Advantage and

includes Part D

To compare two or more Medicare Advantage plans or two or more Medicare Part D plans, or

to get information about comparing a Part D plan with your current health care plan, go to:

Questions?

Call our Insurance Consumer Hotline at

1-800-562-6900

Health Plan Comparison Form Page 3