5 Things To Consider While Choosing Health Coverage

Updated on January 29, 2023

Shopping for suitable health insurance is a crucial aspect of life. However, one who has ever tried it will tell you it is a hectic task. As policies, information and pricing keep changing, it might be confusing to figure out the plan you need. However, there are a few things you need to consider to simplify the search for health insurance.

Prescription Drug Coverage

If presently you are on any prescription medication, examine the prospective plan to see what drugs are covered. You can do so by requesting the list of covered drugs, often referred to as “formularies,” and learning some medicare basics

Usually, insurers have an ordered list of prescriptions available in different tiers. Generic drugs often have the lowest copay costs, while branded medications cost more. So check the potential insurance plan because some insurers ask their patients to try lower-tier medications before being allowed to move on to branded drugs.

Healthcare Network

Most health insurance programs work with a network of providers that include hospitals, individual doctors, and other medical facilities. They negotiate a lower price for care from in-network providers, so as an insured individual, you can pay less for medical services from in-network providers. 

One of the most important considerations for the level of care and the expected cost is the healthcare network available to you. If you have a special relationship with a particular doctor, you may have to find an insurance plan that has that doctor within its network to avoid paying a premium to keep seeing the doctor.


If you have particular medical conditions or think you may need to consult a specialist in the future, find out if you will be able to see a specific specialist, then know which procedure they will require you to follow. Some health insurance plans require you to get a referral before visiting a specialist, while other health insurance plans do not.

If you have a particular specialist in mind, see if the prospective insurance company will accept them.

Do You Want To Contribute to an HSA?

Some people like keeping some petty cash in a health savings account (HSA). An HSA is like savings account you can use for medical expenditures, and it is ideal for those who want to put aside money for medical emergencies. 

Single individuals can contribute a tax-deductible amount of up to $3,500 to an HSA, while those with a family plan can make a tax-free contribution of up to $7,000. Individuals aged 55 and above can make an additional $1,000 in catch-up contributions. However, only particular plans will allow you to make contributions. So, if you intend to add an HSA, find out if your prospective plan would qualify.


If you plan to visit an obstetrician or gynecologist, ensure that your prospective health insurance plan offers your reproductive health needs. So, check if your current OB-GYN is in the network. Also, it’s an excellent idea to check the coverage they provide for pregnancy, birth and postnatal care.¬†

Although all qualified health insurance plans are required to cover childbirth and pregnancy, their level of coverage may differ depending on the plan. Thus, find out how much you can expect to pay out-of-pocket for birth and pregnancy care to determine which plan is suitable for you.

Finding the right health insurance plan is a vital need for your life and those of your loved ones. So, consider their prescription drug coverage, healthcare network, availability of specialists, and whether you will need OB-GYN services, then make the right choice after considering all these factors.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.