Choosing a health insurance plan can be a daunting process. It’s not only costly but can be challenging to select the best plan for you and your family. To be sure that you’re choosing the best health insurance plan, it’s essential to ask yourself several questions. These questions should be based on your health care requirements and needs.
The answers to these questions will help you figure out the ideal plan that will benefit you and other beneficiaries. Here are some of the questions you need to ask yourself before choosing a health insurance plan.
What does the plan cover?
Before settling on a specific plan, you should first understand what it covers. Typically, different types of Medicare cover various health issues. An ideal plan should cover about ten vital health benefits that include inpatient care, outpatient care, lab tests, emergency services, pediatric services, and vision and dental care.
It should also cover mental health and substance abuse treatment, rehabilitation services, prescription drugs, preventive services, pregnancy, maternity, and newborn care.
If your preferred plan doesn’t cover these services or at least half of them, you might need to continue with your homework for a better health insurance plan.
What are you health requirements?
When choosing a health insurance plan, you must ask yourself what your health requirements are. Understanding your health requirements or how often you’re likely to visit the hospital can help you determine which cover is suitable for you.
Each health insurance plan requires you to pay a certain monthly amount. This amount is your premium. In most cases, if you have health insurance through your employer, your premium will be taken out of each one of your paychecks. If you get paid twice a month, you will pay half of your monthly health insurance premium each time you get paid. Each employer may do things differently, but this is a very popular method.
If you’re in good health or you don’t have a chronic illness that requires you to be in a hospital from time to time, you may want to choose a plan with a low premium.
A plan with a low premium has low monthly costs. However, you will have to pay more for almost all doctor’s visits and prescriptions until you hit a certain threshold. This threshold amount is a deductible. After hitting the deductible, you should get full coverage. Some plans have out of pocket maximums, as well as maximum coverages for certain types of procedures.
On the other hand, if you have a particular health condition that often requires health care, it might be best to choose a plan with higher monthly premiums that will cover most of your medical bills. With such a plan, you’ll only have to pay a small amount, known as a copayment, after visiting the doctor or filling in a prescription. You can also view it as an advance payment if you know you’ll need extra medical care.
What are the plan’s limitations?
Each plan has coverage limitations. Therefore it is important to know which kind of limitation comes with different coverage options. This information is available in the plan’s Summary of Benefits and Coverage (SBC). Before paying for a specific program, you must be provided with an SBC with health coverage terms that everyone should understand for easier comparison. Before choosing a health insurance plan, you should always look through the plans Summary of Benefits and Coverage.
How much does it cost?
There are two types of costs you need to know about; monthly premiums and out-of-pocket costs. Out-of-pocket costs comprise copayments, coinsurance, and deductibles. Typically, covers with lower out-of-pocket costs attract higher premiums.
Depending on your healthcare requirements, you’ll be able to choose the right balance between premiums and out-of-pocket costs. If you don’t require regular visits to the hospital, a low monthly premium might be what you need, and vice versa.
Can you still go to your normal doctor?
Do you and your family have doctors you trust and would love to continue with them no matter what plan you choose? If yes, ensure to call them to find out if they are in- or out- of network. It’s important to note that insurance companies charge higher fees to clients seeing doctors who aren’t under their plan’s network. Some plans don’t even cover a single cent of bill from out of network doctors.
Even if your plan pays a part of your bill, the remaining costs might accumulate over time if you continue with your doctor, who isn’t in the plan’s network. Therefore, it would be best to ensure that the doctors in the plan’s network will meet your medical care needs before signing up.
Additionally, you need to understand how flexible it will be to choose a doctor. For instance, health maintenance organization (HMO) plans are cheaper but have few choices when selecting doctors. Clients under such programs may require referrals from their primary care doctors if they need to see a doctor outside their network. However, if you want to see a specialist without a referral from your primary care doctor, you may want to choose a Preferred Provider Organization (PPO) since it has more options.
Does the plan cover prescriptions?
As you did with your doctor, find out if the plan will cover your prescriptions. If it doesn’t, you might have to pay the total amount for your medication. If you’re working with a high-deductible plan, you’ll pay for your medications until you hit your deductible. This means an addition to your monthly costs. It’s therefore essential to review the list of covered drugs and make your decision wisely.
If you have many prescriptions, definition take this into consideration when choosing a health insurance plan.
Can you afford it if you are sick?
Imagine this; you come down with a condition that requires you to be hospitalized for quite some time. Maybe, your partner requires some prescriptions, and your child has to get braces. What happens next? Will your insurance cover all of these bills?
Most people never think of such a situation. It would help to know how much will be paid by the health insurance and how much you’ll pay from your pocket. One thing that may help in a medical emergency is having funds saved it. This can be very helpful to lessen the burden of unexpected medical bills. Here are several tips to build an emergency fund.
No matter what plan you choose, you’ll want once that offers a fair share of protection without exhausting your savings.
Questions to Ask When Choosing Health Insurance – Summary
Choosing a health insurance plan isn’t a walk in the park – it requires a lot of planning, considerations, and discernment. For instance, you need to consider your current health and that of every beneficiary before choosing a given plan. You also have to consider if you’ll require frequent visits to the hospital or not to make the right choice.
If you’re yet to choose a health insurance plan, ask yourself the questions mentioned above, and you won’t go wrong.