Finding the right health insurance plan can be quite a challenging endeavour, particularly if this is the first time you’re doing anything like this. But once you get the hang of it, the decision-making process can truly get as straightforward as can be.
1. Decide on a marketplace
Are you currently employed? If so, you can get health insurance through your employer. This is how the majority of people get insured, and by doing so, you effectively avoid the hassle of having to search the marketplaces. If, however, you’re looking for an alternative, be advised that you’re probably going to need to shell out more. Generally speaking, the federal marketplace offers the most bang for your buck. There’s also the option of finding something through an insurer or a private exchange.
2. Compare the plans
After visiting each single provider’s website, it’s a good idea to write down the crucial pieces of information you’ve gathered and place it in a table. Neatly organize it in any way you like, as long as it makes sense to you and allows you to get a good overview of things. Apart from the costs, you should also list the benefits of each plan. There’s no need to go in-depth – a brief summary will do just fine.
When making the comparison, look at your own medical history and that of your family. Even though your health may take an unexpected turn for the worse, your medical history is a good indicator of what you can potentially expect in the future.
As for the type of plan you should choose, HMO and POS plans are a suitable choice, as long as you don’t object to your primary physician choosing the specialists for you. Since this requires little to no effort on your end, many people might even prefer it. Still, you can opt for the POS plan and still get to choose your own specialists. In this case, you may have to pay a bit more, so to keep the costs to the minimum, visit your doctor for a referral.
3. Research the networks
Health insurance companies often have their own networks of doctors, so to keep the costs to the bare minimum, make sure to stick to the in-network providers. This doesn’t mean that you’re not allowed to venture outside of their network; however, please keep in mind that the costs will be a bit higher in this case. However, some people might have their own preferred doctors that aren’t a part of the network – in this case, simply ask them what health insurance plans they take to make sure you’re covered.
In the opposite case (particularly if you don’t really mind who you visit), you should probably stick to the insurer’s network. Don’t worry, as there are plenty of choices regardless of the fact you’re limiting yourself to a pre-selected list of options. If you live in a big city, it’s unlikely you’ll be running out of them any time soon.
4. Calculate the costs
Until the point of calculating the costs, knowing where you stand will be much harder. When making the calculations, though, make sure to pay attention to your out of pocket costs. If you’re unsure, visiting the government website should give you all the info you need. On the bright side, your yearly out of pocket costs are limited, so there’s no need to break the bank. If you want to know how much that totals to in concrete numbers, just look at the plan you’re interested in; the total should be written on it.
Naturally, you want to be saving as much money as possible, but still; don’t just pick the cheapest option possible. In fact, the plan with a higher monthly premium may be a more suitable option in certain cases. An example of this is if you tend to experience health complications rather frequently, planning to undergo a surgery, or similar.
5. Consider the benefits
Finally, after figuring it all out, made sure you’ve also made an adequate comparison of the benefits. Not all coverage is equal in this regard; while some of it may prioritize physiotherapy, for example, others may put emergency situations at the forefront.
What’s the point of this step? Basically, to find a plan that’s custom-tailored to your needs. Simply go through the options, eliminate the ones you’re the least likely to choose, then work from there. After you’ve nailed it down to the very last couple of contenders, it’s time to pick up the phone and call the insurance company directly (if some of your questions are still unanswered, that is).
If you’re going to make the call, preparing a list of questions in advance seems like a good idea. That way, you won’t forget to clarify important matters when there’s an opportunity to do so. For example, you might want to ask about the kind of drugs that the plan covers. Does the sign-up process require you to submit documents? If so, what kind of documents would that be? Another good question to ask is whether the insurance covers medical treatment while you’re abroad.
An overview of what we’ve discussed today
First, you should decide on a marketplace you want to research more in-depth (remember, if you’re employed, getting insured through your employer may be the easiest one to take). After that, consider your medical needs and choose a plan accordingly. Unless you have a specific doctor in mind, it’s best to stick with the insurer’s network of providers. Then, decide what’s more important to you; saving money or having the best coverage possible? Finally, ask some questions if needed, and when you do arrive at a conclusion, make sure it covers everything you need. That’s the gist of it.
Conclusion
These 5 steps should pave the way towards choosing the right health insurance plan with confidence. Note that there’s no need to follow the system to the very last detail; as long as you stick to the main point of its design, it’s going to serve you well.