Whether you are choosing a health insurance plan from the options provided by your employer, or you are in the market to purchase private healthcare coverage, choosing the right plan can be confusing.
Here are some tips to help you get started.
Understand What the Plan Covers
The Affordable Care Act insures that your plan will cover all of the essentials, such as outpatient care, emergency services, hospitalization, lab tests, preventative care, maternity and newborn care, mental health and substance abuse treatment, pediatric services, and prescription drugs. Understanding how those services are covered is important. Some plans cover office visits and prescriptions before you reach your annual deductible. Other plans require that you reach your deductible, which could amount to several thousand dollars, before you have coverage for prescriptions and/or office visits. Understanding what your plan does and does not cover – and when, is essential to protect yourself and your family.
Look at the Real Cost
When you shop for a health insurance plan, the premium, or monthly cost for the plan, is likely right there and visible to you. It can be tempting to choose a plan based on that number alone. However, there are other things to consider. Generally, plans that have a lower monthly premium have higher out-of-pocket costs.
A deductible is the amount of money you owe your insurance company before it will begin covering most health services, such as hospitalization. This means, if your deductible is $2,000, you will be required to pay $2,000 towards your hospitalization before your insurance company will begin sharing the cost. However, if you are hospitalized again in the same year, the insurance company will cover you immediately, since you have already met your annual deductible.
Therefore, it’s important to look at how much it would cost you if you were to get sick and need an urgent care facility, as well as how much it would cost if you were seriously injured and required hospitalization. Plans with less expensive monthly premiums will have higher deductibles, and some plans with higher monthly premiums may not have any deductible at all.
You should also consider the cost of any prescription drugs you take when choosing the plan that’s right for you.
Check Out the Plan’s Network
Most insurance plans operate within an established network of doctors and hospitals. If you get medical attention outside of this network, your out-of-pocket costs are often much higher, or you may have no coverage at all. Therefore, it is important to understand the plan’s network.
Some less expensive plans have much smaller networks of doctors. This is not necessarily a bad thing, but if you have a specific doctor you prefer to see, it is important to find out whether he or she is a member of the network. You can find this information on the insurance company’s website, but we suggest contacting your doctor personally because the provider directories, even online directories, could be out-of-date.
Compare Multiple Plans
Always take a look at multiple plans when evaluating your best option because similar coverage can vary in price.
With the changes to the healthcare industry over the past several years, it’s good to have an expert on your side to help guide you through your choices. Let us help you choose a health insurance policy that fits with your individual needs and budget. You can call us directly at 800-524-6390 or fill out our contact form for more information.