What to Look for in a Health Insurance Plan

With all the insurance options available today, choosing a health insurance plan can be confusing.   To make your search for the right plan a little easier, consider the following suggestions.

Research several health insurance plans to find the one with the lowest cost.   Many employers offer two or three different health insurance plans, and it’s up to you to decide which plan is the most cost effective for you.   Use an online health care insurance cost calculator to determine which plan best suits your needs while giving you the best price.   If you are self-insured, spend some time visiting health insurance Web sites and compare the costs for different plans.   Make sure you are comparing costs for similar plans.

Choose a plan that gives you access to the providers you want to use.   Traditional health plans allow you to choose any healthcare provider or facility.   These plans generally cost more than Health Maintenance Organizations (HMO) or Preferred Provider Organizations (PPO).   HMO’s require you to visit doctors specifically associated with their organization.   PPO’s negotiate contracts with healthcare providers and facilities for reduced rates, and you are encouraged to use these contracted providers.   PPO’s usually let you use non-contracted providers as well, but you will pay more for these visits.   If you prefer particular doctors, specialists, or hospitals, make sure they are covered under your selected health care insurance plan.   You can get a list of a health insurance plan’s providers before you commit to the plan.

Look at the required copayments and deductibles.   A copayment is the amount of money you must pay for a healthcare service.   Copayments are sometimes a set amount, such as $25, and sometimes they are a percentage of the total cost, such as 20%.   A deductible is the total amount you are required to pay before the health insurance company benefits are activated.   Coverage for some healthcare services, such as preventive care, is provided before the deductible is met.   Keep in mind that health insurance plans with low copayments and deductibles usually have higher premiums than plans with higher copayments and deductibles.

Make sure the health insurance plan covers everything you need.   If you require periodic visits to a specialist, medical supplies, or ongoing prescriptions, check the health insurance plan’s coverage of these items.   No one can predict what type of healthcare services they will need in the next year, but try to determine what you will most likely need.   If your insurance plan does not cover current or possible needs, look for a plan that does.   Your savings from a lower-priced plan will soon be gone if your coverage doesn’t meet your healthcare needs.

Look at the pre-existing conditions policy.   Some insurance policies will cover pre-existing conditions, such as high blood pressure or diabetes, and some   will not.   Caring for a health condition can become quite expensive without the proper healthcare coverage.   If you are not sure if a health plan will cover your pre-existing condition, talk to a customer care representative to find out.

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