Getting health insurance is one of the best investments that you can make for yourself and your family. However, it can be challenging to find a health insurance policy that covers everything you need and want. There are also other factors like price, which can make choosing more difficult than it already is. This article will list tips to help you select the most suitable insurance plan so that you can get the coverage you need.
1. Compare plan types
There are different health insurance types available. Each type is designed according to meet various needs. It’s crucial that you compare health plans before jumping into a purchase because some types have certain restrictions. You want to be informed beforehand so that you can maximize your insurance benefits. You can consult with a health insurance broker if you are unsure of what to pick.
Examples of plan types are:
- Health Maintenance Organization (HMO)
This plan is a fixed package of health care services for a fixed cost, with a network of health professionals and facilities. The out-of-pocket costs are often lower with an HMO, and there is usually no need for claim forms, but specialists may require a referral from your primary physician.
- Preferred Provider Organizations (PPO)
PPO plans have a managed care similar to HMO, with the flexibility of being able to go to health facilities and professionals of your choice when you think that it’s necessary to do so. There will be more unpredictable costs to pay for going outside the network, but you will still have some coverage.
- Fee-for-service or Indemnity Plans
This plan allows you to visit any doctor or specialist that you prefer without the need for a referral, and your insurance company pays a fixed amount, then you’ll pay the remaining cost. These plans can cost more compared to HMOs and PPOs.
2. Consider your doctors or specialists
As mentioned above, there are health insurance plans that require you to use their network of doctors and specialists. You might think that you don’t need specialists, but think about your OB-GYN, your kid’s pediatrician or pediatric dentist, or your physical therapist. If you currently seeing a healthcare professional and want to continue, it’s best that you check which network they might be in. In case they aren’t in any of your choices, check to see how much out-of-pocket costs you might incur.
If you need to choose a new doctor from a specific plan, remember to:
- Research the doctor’s credentials and background
- Read doctor reviews online
- Look into medical associations they are with
- Check if their location and availability is feasible to you
- Ask family, friends or colleagues who are under their care for feedback
3. Don’t neglect pre-existing illness
Some types of health insurance plans don’t cover pre-existing conditions, which will be a problem if you or your family member has any of those. Ensure that you are clear about the coverage for these types of illnesses and if there are waiting periods before you can use them. This is very important when picking your insurance plan.
The most common pre-existing conditions are:
- Hypertension or high blood pressure
- Mental illness
- Chronic Obstructive Pulmonary Disease (COPD)
4. Check the Prescription drug package
Prescription drugs can be included or excluded in a health insurance package. If you’re taking prescription pills regularly to manage a certain condition, don’t forget to clarify about its inclusion. The medications that you take regularly won’t be inexpensive in the long run, so you want to make sure that you can get this covered with insurance.
Other ways that you can save on prescription drugs are:
- Print out the list of medications your insurance covers and show them to your doctor.
- Compare the prices of your insurance’s recommended pharmacy from others.
- Use discount programs or coupons from local pharmacies as much as you can.
- Buy generic medications compared to brand name ones, with the consultation from your doctor.
5. Know the cost
Last but not the least, choosing the best insurance plan includes the price that you need to pay. The lowest prices don’t always mean the most affordable, and the most expensive ones don’t always mean the most coverage. It’s crucial that you know the insurance packages before making a decision, and comparing between health insurance companies.
Here are some considerations:
- Find out how much insurance deductibles you need to pay.
- Know how much your limits are – per illness, per month, annually, or whichever is applicable.
- Estimate how much you’re going to spend for out-of-network expenses.
- Check the out-of-pocket maximum listed in each health insurance policy.
Healthcare costs aren’t cheap, and health care insurance plans can make those trips to the doctors much less stressful than it already is. There are many plans available in the market, but don’t jump into buying one immediately. Use the tips provided above to guide you in your decision to make the most out of your health insurance plan.
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.