Selecting Your Plan

Selecting the Best Plan for You and Your Family

Selecting the right health care plan is an important decision. STRS Ohio makes the decision-making process easier by offering plans that include hospital, medical and prescription drug coverage. Separate dental and vision insurance is also available.

What’s Most Important to You?
Before selecting your plan, you should decide what is most important to you. Some health care plans have different coverage levels, so you should ask yourself these questions:

• How comprehensive should my health care coverage be?
• How much am I willing to spend on monthly premiums and other out-of-pocket expenses?
• How important are limits on my choice of doctors or hospitals?
• How do I feel about a primary care doctor referring me to specialists for additional care?
• How convenient does the location of my providers need to be?
• Am I or any of my family members eligible for Medicare?

You should also think about whether the services a plan offers meet your needs:

• Are you and your family members relatively healthy?
• Is 100% coverage for preventive services important to you?
• Do you or your family members have any chronic health conditions or disabilities?
• Would you benefit from health management services at no additional cost?
• Are you or your family members taking many prescription drugs on a regular basis?
• Do you or your family members travel frequently or spend time at two homes?
• Do you have any children in college who need coverage?

Features to Consider When Comparing Plans
After you decide what’s most important to you, you should begin comparing plans. Features to consider include services offered, choice of providers, location and costs.

• Services — Look at the services offered by each plan. Are any services limited or not covered? Is there a good match between what is provided and what you think you will need?
• Choice — Which doctors, hospitals and other medical providers can you use? If you want to see a specialist, can you refer yourself or does your primary care doctor need to refer you? Do you need approval from the plan before going into the hospital or getting specialty care?
• Location — Where will you go for care? Are these places conveniently located? How does the plan cover services when you’re away from home?
• Costs — How much will you pay for your monthly health care premiums, including Medicare Part B (if applicable), and other out-of-pocket expenses? If a plan does not cover certain services or has higher copayments for prescription medications that you think you will need, how much will you have to pay? Is there a limit on how much the plan will pay for your care in a year or over a lifetime? Although you may not know in advance what your health care needs will be for the coming year, you can think about the services you or your family might need. This will help you estimate what your total costs might be for services under each plan.