What to Know Before You Pick a Health Insurance Plan
Updated: Mar 7, 2022
Health Insurance is confusing for a lot of people due to all the different types of plans and unfamiliar terminology. With Open Enrollment right around the corner, now is the time to take a deep breath, gather up your necessary paperwork, and select a health insurance plan for 2020. Whether you’re shopping for an individual healthcare plan or a family plan, there are certain things you need to know.
Things to keep in mind when shopping for individual health insurance plans:
With so many different variances & types of health insurance coverage, it can be tricky to know where to start. If you currently have a mild to a severe health condition, chances are you probably have a decent grasp on how to select the coverage that you need, to help you afford the conditions you are currently living with. However, if you are a younger, seemingly healthy individual, it can be harder to figure out how much coverage you actually need comparatively.
What do you think your life is going to look like over the next year?
As previously mentioned, if you are currently living with a condition that requires regular medical attention chances are you know what kind of coverage you need, because chances are you have been dealing with this problem for a lengthy period of time. However, for the rest of the general population, the whole reason for health insurance is to give you protection against the unforeseen medical circumstances that life throws at us.
You need to think about what could possibly be lurking around the corner, and prepare yourself for the unknown.
Only Pay for the Coverage You Need
Just like any other product or service, you shouldn’t purchase something you don’t need. However, health insurance is not something you should skimp out on, but that doesn’t mean it needs to break the bank either. When comparing coverages and plans, some may have more than you personally need right now. That is why it is important to carefully read and understand what is included in the packages so that you don’t end up paying for something that you don’t really need.
Know Your Network
If you currently have a primary care provider or specialist that you visit regularly due to a medical condition you live with and are deciding to shop for a new health care plan, you need to make sure that the doctors that you like to visit are listed in that new insurance network. Otherwise, you could get a new health insurance plan and end up not being able to visit your physician of choice due to that change in insurance, or you could still visit them and end up paying much more than you’re used to out of pocket.
Will Your Prescriptions be Covered?
If you rely on your health insurance to foot the bill for your current prescription medications, you need to make sure that any health plan you enroll in provides you with the same kind of financial help towards those sometimes pricey prescription drugs. Most plans have similar coverage for prescription medications, you will just want to double-check that the co-payment to receive the drugs are reasonable. In today’s day and age, there are lots of online coupons to save on prescription medications like GoodRx.
Things to keep in mind when shopping for family health insurance plans:
Choosing a health insurance plan can be complicated. Knowing just a few things before you compare plans can make it easier for you to make the right choice. Here are some concepts and things to keep in mind when buying health insurance for your family.
Learn About Deductibles
You should be aware that your plan may have a family deductible in addition to individual deductibles for each family member. Many times, individual deductibles are lower than the family deductible. Once an individual hits their individual deductible, their health insurance plan kicks in just for them. But once the family deductible is met, health insurance kicks in for every member of the family, regardless of whether or not someone has reached their deductible on their individual level.
4 “Metal” Categories
Other things to keep in mind while choosing the right plan for you and your family include the 4 “metal” categories, total costs, and choosing the right plan/network types. Something you might not know is that there are 4 tiers of health insurance plans. Bronze, Silver, Gold, & Platinum are the 4 different levels available. Each of these categories has different costs and coverages, so make sure to compare the differences and look at the breakdown of how you and your plan share costs.
Consider Total Costs
Secondly, you need to consider your total costs for healthcare. You pay a monthly premium to your insurance company, even if you don’t end up using your health insurance that month. You also have out-of-pocket expenses including deductibles when you make a visit to receive care. It is wise to think about both of these costs when you are shopping the market for a new health insurance plan.
Choose the Right Plan
Lastly, it is important to choose the right plan/network for you and your family. There are a few different types of plans out there such as HMO, PPO, POS, and EPO. Depending on the type of plan you go with, you might have limited options on which doctors or health care providers you can visit. If you choose to visit a doctor that is outside of your plan’s network, you could end up being charged more for using a provider that is out of their network.