Top 5 Tips for Choosing the Right Health Insurance Plan

Choosing the correct health insurance plan is one of the single most important financial decisions you greatly influence. Unanticipated medical expenses are also on the rise, and what having the right insurance does for you is protect your health in case of a medical emergency as well as protect against rising healthcare costs that can devastate your financial health. On the other hand, there are so many plans available to choose from that they can become dizzy just trying to pick one. To make the process easier, below are the 5 best tips on opening your adventure of picking a health insurance plan.

Assess Your Healthcare Needs

The various health insurance options have specific purposes, but the best option for you is going to depend on what your current and future healthcare needs are. Consider the following:

• Do you have a chronic condition that requires medication?
• How often do you go to the doctor/see a specialist?
• Will you need cash for a big medical expenditure (surgery or childbirth)?

How often you use healthcare services: The more you understand when and how much healthcare you are likely to use, the better. This will help determine which set of plan benefits is right for your household and which benefits may be overkill. For those who are well, a plan with smaller monthly premiums but higher deductibles might be the cheaper way out. But if you require care often, a full plan with more coverage may be the way to go.

Appreciating the variety of plan types

There are different kinds of health insurance plans and it is important to know the differences so that you can choose the right option. They come in different shapes, sizes and are made for various purposes but some of the popular ones include:

• Health Maintenance Organization (HMO): Covers care from doctors, hospitals in the plan’s network. Usually less expensive but with a narrower range of health providers
• Preferred Provider Organization (PPO): Provides greater choice of doctors and specialists at a high-cost premium
• Exclusive Provider Organization (EPO): This is very similar to an HMO, but members will not need a referral to see specialists and care from out-of-network providers is not covered
• Point of Service (POS) – a mix between HMO and PPO, allowing referrals to specialists but offering more choices for out-of-network coverage

There are perks and drawbacks to each plan type, so weigh how much you value freedom in choosing your healthcare providers versus how much you’re willing to pay in premiums.

Check Coverage and Benefits

Before even selecting a health insurance plan, it is paramount to know what is covered and what is not in the plan. Consider the following:

• Are your medicines in the plan?
• Preventive care: Do they cover all annual checkups, vaccines, etc. or not?
• Emergency care: What is the coverage for emergency room visits, hospitalization?
• Mental health treatments and wellness services: Does the coverage include counseling, therapy or any form of mental health treatment?

In addition, some plans provide additional benefits such as maternity coverage, dental and vision care, or wellness programs. Make sure you can get your medical basics while not paying for some services you will never use.

Compare Costs Beyond Premiums

Premium costs are important, but they are not the only thing to think about when selecting a plan. Also, be sure to ask about the following expenses:

• Deductibles: This is the amount you pay before insurance coverage begins. The cherry on top is, the higher the deductible, the lower the monthly premium
• Copayments and coinsurance: This is the percentage of medical costs you’ll have to pay after your deductible has been met. Also note that some plans may have a flat copay while others pay a percentage of the costs (coinsurance)
• Limit of out-of-pocket maximum: The most you pay for covered services in one year, including copayments, coinsurance, and deductibles. Once meeting this limit, the insurance company pays 100% of all your medical bills

While a low premium plan may look enticing, it may be paired with a high deductible and copays so that when you do require medical care (which hopefully is rare) the out-of-pocket expenses can add up. Keep this in mind if you go for an ObamaCare alternative.

Check the Provider Network

Every health insurance plan has its own overall network of doctors, specialists, and hospitals. Confirm your favorite doctors, hospitals, and other providers participate in the plan you are choosing before signing up. Many times, people have a relationship set up with doctors or specialists and this is key for them.

In-network providers usually have service rates that are lower because they have agreements with the insurance company.
Non-participating providers do not have contracts with your insurance company, however, they may still bill your insurance and you might incur a higher cost as co-payment or get no coverage at all.
If you care about keeping the doctor you have, make sure that your current doctor is in the plan.

Conclusion

Picking out the health insurance plan is finding a sweet spot between your healthcare demands, your budget, and also the flexibility you need. Helping you identify plan types, coverage options, costs, and provider networks that allow you to breathe easy and feel confident about protecting your family. First, determine the priorities you have when it comes to healthcare & if need be, don’t shy away from taking advice from a professional. And remember: the best health insurance plan for you will save you money and provide the kind of coverage you need when you need it most.