Choosing a health insurance plan is not easy. There are so many options out there and selecting just one can be overwhelming. You want to get the most affordable cover with the most lucrative benefits. What this is will depend on what your health needs are among other considerations. How can you decide on the best plan? Here is a useful guide.
1. Consider Your Health Needs
Do you have any underlying condition for which you need ongoing healthcare? What about your family members? If anyone has such a condition, the plan you pick should cater to the treatment course. Whether it is diabetes, cancer, or allergies, you need to choose a plan that covers this. Also, think of future issues that may arise with your health. For instance, if both your parents suffer from high blood pressure, you are at a high risk of getting the illness even if it has not set in yet. Also, look at the history of your family’s health. What type of care have they needed the most? The plan you choose must cover these.
Not all healthcare plans cover specialist treatment. If you think you may need to seek the services of a specialist in the future, choose a cover that pays for this. If you are already working with a specialist, check if the plan will cover your costs to continue treatment.
2. The Healthcare Network
This refers to the healthcare providers contracted by the insurance cover to provide its clients with medical care. There are different kinds of plans. Health maintenance organization (HMO) plans have specific doctors, hospitals, and medical services providers who will treat people on the cover. HMO is usually an affordable plan because the providers have agreements with the insurance company. You have to choose from the providers within the network whenever you need treatment.
The other option is a preferred provider organization (PPO) health plan. With such a plan, you can get treatment from any medical provider you want. However, this plan attracts high out-of-pocket payments for consulting with out-of-network providers.
It is important to understand the differences between HMO and PPO. Choose a plan that has a vast network and allows local in-network doctors.
4. Understand the Terms
As you read through different plans, there are common words that you will find. Understanding what they mean will help you make the right choice. Below are a few important words:
- Premiums – This is the amount of money you will be paying to the provider every month. It differs from one plan to the other with higher premiums providing more vast coverage
- Deductibles – This is the amount of money that you will need to use on your healthcare before insurance comes in to pay for the rest. When the deductible needs to be paid will differ depending on the plan. While some only require deductibles to be paid for procedures, other plans have different deductibles for medication and medical services
- Copay or co-insurance – This is the percentage of your medical costs that you will need to pay while insurance covers the rest. It may be 20%, less, or more depending on the plan. Copay is calculated per procedure or hospital visit
- Out-of-pocket costs – This is a total of everything you need to pay towards your healthcare other than the premiums. It includes copays, coinsurance, and deductibles. Plans have a maximum set amount. If your out-of-pocket payments reach this limit, your provider will pay for all your medical costs for the rest of the year.
When looking at different health plans, not the amounts set for the above terms. Choose a plan that is favorable to you.
5. Use Underwriting Software to Compare Plans
With so many plans to choose from, comparing could take a long time. To help you navigate comparisons fast, make use of the best underwriting software. This is what insurance agents use to choose appropriate plans for their clients so you can trust them. Underwriting software provides a head-to-head comparison of different plans. At a glance, you can know the plans that are available to you and compare quotes. Restrictions of each plan are clearly explained to help you make an informed decision.
With the above considerations, you will easily get a health plan that suits your needs. Be sure to prioritize your specific needs when making this choice. Take time to compare different plans so you only settle for the best.
