Before you choose your health insurance plan, you must understand your needs and do your research. Do not purchase the first plan you come across without first carefully comparing your options. If you have health insurance benefits through your employer, you are one of the lucky ones, but many people nowadays are finding themselves in need of private health insurance to cover their medical costs.
What do I need to consider before researching a health insurance plan?
Before you begin your research on a health insurance plan, you must know what you are looking for. You need to consider both your medical needs and your monthly budget. It helps to begin by asking the following questions.
- What can I afford to pay in terms of a premium?
- How frequently do I typically visit my doctor or any specialists?
- Do I need the plan for myself alone or for a spouse or larger family with children?
- Do I have health conditions that may cause my medical needs to be greater but also limit my availability of insurance for pre-existing conditions?
- Am I willing to switch doctors if my doctor is not part of the network for the company I choose?
What types of health insurance plans are available?
You also need to understand the types of plans typically offered by standard insurance providers before starting your research. Each plan has pros and cons and you need to understand how each one works to be able to make an informed decision.
HMO/Health Maintenance Organization – This common type of health insurance plan is typically more affordable but offers fewer options. You must choose a primary care doctor from a list of network doctors, and you are only allowed to visit medical professionals within that network. Before seeing a specialist, you must obtain a referral from your primary care physician.
PPO/Preferred Provider Organization– This type of plan costs slightly more but gives you more flexibility and options. You usually do not need to choose a primary care physician and you a referral in not needed to visit a specialist. The network of doctors is typically larger because a PPO is set up so that the doctors have agreed to provide care at a greatly discounted rate in return for business from the insurance company.
Catastrophe Insurance Plans – These plans come with a low premium in exchange for a high deductible you would play for a major medical issues before insurance would kick in. You would save a lot of money each month but pay an increased co-pay for even routine care.
Indemnity Insurance – These traditional fee-for-service plans are set up so that you initially pay out of pocket for medical services, but are then reimbursed a percentage of the cost by the insurance company.
IPA/Independent Practice Association – This is a group of doctors who have partnered to form an independent network. They treat patients who enroll in this network for a standard co-pay.
HSA/Health Savings Account – These are typically established in connection with other types of insurance plans. With these accounts tax free income is set aside to cover medical expenses.
For additional unbiased information on the types of insurance plans available, finding affordable health coverage, and The Affordable Health Care Act, you may want to visit www.healthcare.gov.
How do I narrow my search for a health insurance company?
If your employer provides you with health insurance benefits, you are all set. While you have fewer options and may have to settle for a plan that is not tailored to your specific needs, you will pay much less, because your employer will pay the bulk of the premium.
If you do not have employer health benefits, you must find your own insurance company and plan. A good place to start is by getting recommendations of companies and insurance plans from family members and friends you trust. This will give you a basis to begin your search. After this, here are some steps you should consider taking:
Get rate quotes from several health insurance providers in order to rule out those that are beyond your budget.
Compare the plans offered by each company, their cost, what they offer, and their exclusions.
Find out if your doctor or any specialists you regularly visit are part of each company’s network. Consider whether you are willing to switch doctors if they are not in the network of the company you choose.
Narrow down the plans and compare them side by side. You want to make sure you choose a plan that will meet your needs. A decent insurance plan will have a broad network of doctors, will cover 100% of your medical expenses beyond a set deductible, and will cover a wide array of medical services such as mental health care, rehabilitation, and chiropractic care. You can visit websites such as www.ncqa.org or www.consumerreports.org to find out more information and read reviews of specific companies.