How To Choose Your Health Insurance

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Choosing a health insurance policy that covers everything you need can be difficult. The changes with the Affordable Care Act have changed the process too. It is important to make sure that your plan meets those requirements. Your employer may offer numerous insurance plans and all of these should meet the Affordable Care Act requirements. It is important to carefully consider your options before determining which plan to use.

There are several factors that can change the outcome of your decision. It is important to find a plan that works well for you.

Consider the Coverage Limits and Options

The first thing to consider is how much each plan will pay to cover your expenses. A good plan will have no lifetime benefit maximum. If something such as cancer were to happen to you, you would be surprised at how quickly you will reach that limit. If you do not have the option of the no lifetime benefit maximum, you should choose the highest available maximum and annual maximum you can afford.

Look at Your Out-of-Pocket Expenses

You should look at how much your deductible is each year, as well. This is the amount that you have to pay out of pocket before your insurance will start paying for part of the cost. Some insurance plans have you pay the deductible before they will cover office visits. Other insurance plans require a co-payment for office visits and do not count that amount towards the deductible.

You need to look at how much your co-payments and co-insurance are. Your co-payment is the upfront cost you pay to go to a doctor, a specialist or the emergency room. Your coinsurance is the amount of each bill you are responsible for after the insurance pays its part. The most common coinsurance amount is 80/20.

The insurance will pay eighty percent of the costs, and you will pay twenty percent of the costs.

Next, consider the out-of-pocket maximums that each plan has listed. Once you reach this limit your insurance will cover everything else (except for co-payments). If you have a high deductible health insurance plan, your maximum out-of-pocket costs should be the same as your deductible. There are hybrid plans with a high deductible that continue to require co-payments after you meet the deductible. These accounts will not qualify for health savings accounts.

  • Consider your deductible, co-payments, and co-insurance
  • Look at the limits on coverage
  • Compare out-of-pocket maximum

Total Your Maximum Costs

Finally, add up how much you will end up paying from each plan if the worse thing were to happen to you. Be sure to add in the cost of insurance to yourself for each plan. If you have poor health, you will want to choose the plan that will cost you the least amount out of pocket for the entire year. If you are in relatively good health, you may choose to go with the plan with the lowest premiums or you may decide to go with the middle option.

  • The best policy may not be the least expensive policy depending on your situation
  • Look for ways that you can save once you have your health insurance
  • Do not forget to include plans offered by your employer in your search.

Don't Write Off High Deductible Insurance Options

Many employers are beginning to offer high deductible insurance. This insurance has a lower premium, but you are responsible to pay for everything until you meet your deductible. The deductible is anywhere from $1000.00 to $5000.00 per family per year. If this is the case, you should set aside enough money to cover the deductible each year. Try to avoid using a health share which sounds like health insurance but it works differently and may not give you the same amount of coverage. You should also avoid hybrid plans that have a high deductible before coverage starts, but then has you continue to pay co-insurance and co-payments.

It can end up costing you more than either of the other options.

Make the Most of Your Health Insurance

Once you have found a good plan, it is important to make the most of your policy. Read the benefit booklet. Make sure that you understand the different rates that are charged for different services. For example, an x-ray may be covered at an urgent care as part of the visit, but may not be covered fully if your doctor orders one and you have to visit a separate lab to get the x-ray. Call your insurance company and verify coverage before any medical procedures. Visit your doctor and try to limit urgent care and emergency room visits. It is also important to carefully review the medical bills that you receive and dispute any mistakes that are made. The process can take time, but it is important to make sure you are not paying more than you are required to since medical bills can add up quickly.