How To Choose The Best Health Insurance Plan
With the ever-rising cost of healthcare, having a good health insurance plan has become a necessity rather than a luxury. But it’s not always easy to figure out which plan is right for you and your family. There are so many options out there, and there are numerous factors to take into account in making a choice.
If you have a plan or plans offered to you through your employer, that helps to simplify the choice since employer-based health insurance is always going to give you a good group-rate discount.
But regardless of where you get your health insurance or what kinds of extra discounts you can get, there are certain criteria that should always play into your final decision – including these five!
1. The Extent of Coverage
All too often, people who shop for health insurance focus so much on the cost that they forget to pay adequate attention to the issue of what they are actually buying. That is, you want to get sufficient coverage for your needs and that of your family members who may be on the same plan with you.
For example, with marketplace plans, the coverage level is gauged by “metals.” Bronze plans cover 60%, sliver plans 70%, gold plans 80%, and platinum plans 90% of most medical bills.
If you are likely to have a lot of medical expenses in the year ahead, it could be worthwhile to pay extra for a higher-coverage plan. But if your bills are probably going to be minimal, you might save more with less coverage.
2. Total Out-of-pocket Cost
Next to considering what health insurance does cover, you need to look at what it won’t. No plan can cover everything 100%. All plans leave you with some out of pocket costs, so it’s a matter of making sure they won’t likely be too burdensome.
The most obvious out-of-pocket cost is your monthly premium. But you also have to ask if the plan has a deductible, and if so, how high it is. Copays and coinsurance come into play as well.
Finally, many plans offer an annual maximum, which is the most you can be required to pay out of pocket for covered expenses in a given year. That’s obviously a very important number to pay close attention to!
3. Specific Types of Coverage
Aside from getting enough coverage at a good rate with low out-of-pocket costs, you need to ask some pertinent questions concerning how coverage “rules” apply to specific needs you may have.
For example, if you are or may soon become pregnant, you want to ask about maternity and birth-related coverage. If you have a specific preexisting condition or are expecting to undergo a particular surgery soon, find out about those items specifically. Ask your insurance agent.
If you tend to have frequent visits to urgent care facilities or ER centers, then you definitely want to find out if those types of visits are covered somewhat differently (and they often are.)
4. Prescription Drug Coverage
Prescription drugs are sometimes such an important issue that people buy a special additional plan of some sort to help with those expenses. But most need not do that. Just be careful to choose health insurance that will cover prescription drugs adequately for your anticipated needs.
Find out to what extent prescriptions are covered. Find out which types of drugs are or are not covered. And definitely compare the copays on brand name versus generic drugs of the same kind. There may be a brand name prescription drug you take and want to keep taking, so you don’t want to be surprised by the copay!
5. Connections With Local Providers
If you get your health insurance through your work, you can bet that you will have easy access to local healthcare networks where you can maximize your insurance-based discounts.
And there will certainly be local providers available regardless. But the point here is that some plans are only accepted for a maximum discount by certain physicians, hospitals, and other health-related services. Thus, you want to take time to investigate exactly where you get the highest discount with your plan and, if applicable, compare that to your current preferred PCP and other providers.
There are many, many factors that go into choosing a new health insurance policy, of course. These are only five of the most critical ones. You may, perhaps, have further questions.
To learn more about how to select an ideal plan or to speak to an experienced health insurance agent in a free, no-obligation consultation, contact the experts at Flagler Financial today!