5 Considerations When Comparing Health Insurance Plans
According to statistics from PBS, approximately 44 million Americans are without health insurance, which indicates that almost one-third of U.S. individuals have zero security when it comes to the health and wellbeing of themselves and their families. Being uninsured at any age is linked to lower rates of prescription medications, yearly doctor’s visits, delayed preventative and vital medical care. It also means that these individuals are more likely hospitalized for preventative health issues.
Facing the enormous cost of medical bills without health insurance is a black hole of financial debt. Here’s how to compare health insurance plans so you can secure immediate health insurance at an early, healthy age to ensure all of your health needs are covered:
1. Prescription coverage
While you may not have an existing condition now (i.e., diabetes or high cholesterol), you may face a diagnosis later in life that requires prescription medication on a daily basis. When considering plans, ask your potential provider how many drugs are covered across categories. For instance, many health plans assign the drugs that they cover to “tiers”, and may only cover a limited amount from each category. So before going with a certain provider, ensure the drugs you need are explicitly covered on your policy
2. Cost-sharing or out of pocket services
You’ll notice terms like out-of-pocket maximums, copayments, coinsurance and deductibles in health policy verbiage. These terms refer to cost-sharing, meaning your insurance provider will share the cost with you. It’s important to know what these terms explicitly mean:
- Out-of-pocket maximum: The max cap on the cost to you during the annual coverage time frame.
- Copay: A fee paid up front by the insurance holder (you) pay for specific services (i.e., doctor’s visits).
- Coinsurance: The paid percentage of your medical bills paid by you after the out of pocket deductible is met. So if your copay is 30%, your insurance provider is agreeing to pay 70% of your medical costs.
- Deductible: the amount the policyholder (you) has to pay before an insurance provider contributes.
3. Estimate your medical needs
Before going with any health plan, map out your expected affordable health care needs for the year. Do you normally get a sinus infection and need to see a doctor and get prescription medication? Are you scheduled for any procedures or surgeries? While some medical costs are emergency in nature, others can be calculated if you have certain medical needs (i.e., an existing condition) so you can determine your needs based on this foreshadowing.
4. Medical and doctor network
Every health insurance provider will list a network of medical facilities and doctors covered by them. Ensure your doctor and regular medical offices are listed within this network, or else the understanding is that you will pay out of pocket. If you’re fine switching health providers for one in the insurance network, make sure they offer quality alternatives within your geographical location. You don’t want to be stuck driving hours to an in network provider during an emergency.
5. Monthly premium cost
Perhaps most important is the cost of your monthly health insurance premium. This should be based on how much you can afford to pay each and every month for health coverage. While this shouldn’t be the sole consideration when choosing a plan, this expense will often determine the quality of your plan’s coverage.
Find out more about how to buy affordable health insurance that covers both individuals and family needs at ehealthinsurance.com.