8 Tips for Choosing Health Insurance
Be wise when you buy
It’s not easy to find the right health insurance plan, regardless of whether your employer offers it. Nearly half (50%) of all employers employing 200 or more employees offer several plans with different premiums. They also have different copayments, benefits, and deductibles. These are some tips to help you choose the best insurance policy for you and your family.
Look after your health
A plan with a lower copayment and deductible is recommended if you have ongoing medical conditions such as heart disease or diabetes. If you’re thinking of having a baby, the same applies. Although you will pay a higher premium your overall out-of pocket costs could be lower.
Do the math.
The monthly premium is often the most important thing, but it’s also important to consider the amount of the deductible. If you have to choose between a lower premium for silver plans, at $345 per month, with a $5500 deductible, or a premium for gold plans, at $465 per month, with a $1750 deductible, the better option is the second plan, especially if your medical needs will exceed $1,500. Your total annual premium and deductible will be $7,330. That’s a $2,310 saving over the lower plan.
Consider out-of pocket costs.
The deductible is only one out-of pocket expense. You also have copayments or coinsurance. The sum of these three is your maximum out-of pocket cost. According to the Affordable Care Act the maximum out of pocket limit is $7150 for a single person, and $14,300 if you have a family policy.
Examine the provider list.
Many health plans now have “in network” providers. These doctors and hospitals will save you money than if they were outside your network. You can keep your own doctor and visit a specific hospital, but make sure they are on the provider’s list.
See the full list of benefits.
Individual and small-business plans must include coverage for hospitalization, emergency care, lab tests and maternity and newborn care. Outpatient care (doctors or other services received outside of the hospital) and pediatric services (including vision care and prescription drugs), as well as preventive and therapeutic services. Your employer’s specific plans may have different coverage. Please review the Evidence of Coverage.
Check out the drug list.
Each plan comes with a formulary. It lists the medications they cover as well as the copayment. Prescription medicine: Check the list to find out if your medication is included and what refills cost. If your medication isn’t on the list, you might have to pay in full. For prescriptions that you use on a regular basis, check to see if your plan has a mail-in option.
Ask the right question.
You can call the member service department of the health insurance plan you are interested in or speak with someone in human resources to ask questions such as: Which doctors, hospitals and clinics participate in this plan? How much does it cost for me to get out of the network? Are I covered in case of an emergency? What is the cost of both the premium and the out-of pocket costs? What is the maximum I will have to spend out of my own pockets to cover expenses What benefits are covered and what isn’t? How is a dispute about a bill/service handled?
Make sure you are satisfied with the plan’s quality.
It takes just a few clicks to check the quality and reliability of your plan. The National Committee for Quality Assurance ranks the quality of health plans across the nation based on clinical performance, member satisfaction and results from NCQA surveys.