When it comes to health insurance, one size does not fit all. With all the talk about affordable health care, it can be very confusing to select the right plan. The secret to choosing the best plan to meet your needs lies within your medical history. The following seven tips will guide you to make the best insurance decision for your healthcare needs.
1. Know Your Acronyms
There are different types of insurance plans that you can choose from. Take the time to familiarize yourself with each and learn the basics of how they work.
- Health Maintenance Organizations (HMO): Require you to use providers within a set network. The co-pays, deductibles, and overall premiums are more affordable because of the restrictions.
- Preferred Provider Organizations (PPO): Allows you to see any doctor within network or out-of-network. Considered a premium plan with a higher cost.
- Point-of-Service (POS): Is a hybrid of the HMO and PPO. You are required to select a primary care physician (PCP), and costs are low if services rendered are in-network. Out-of-Network services are available at a higher fee but require a PCP referral.
- High Deductible Health Plan (HDHP): These plans have extremely high deductibles, and the insurance provider will not pay for costs until you meet the deductible. The cost for the plan is very low.
2. Review Your Past
Now that you understand the plans available review the last 12 months of your health history. How many times have you or any of your dependents visited the doctor? What were the reasons for the visits? If infrequent, selecting a plan with lower premiums would be more cost-effective.
3. Analyze the Future
In the next 12 months, do you or your dependents have any surgeries or hospital visits planned? If so, it is not recommended to choose an HDHP because you will have a very high deductible to meet before the insurance company assists with payment.
4. Call Your Doctor
If you have a great relationship with your doctor, ask about in-network plans. Staying in-network will keep costs low. You don’t want to lose a great relationship with a trusted healthcare provider.
5. Prescription Coverage
Daily maintenance prescriptions are vital to your health. Before selecting a plan, ask if your brands are covered. If not, check with your doctor to see if a generic version will suffice. If not, take this cost into account. In the end, prescriptions can negate any plan savings you may have gained.
6. Calculate the Cost
Sure, an HDHP may seem like a great idea if you do not visit the doctor often, but take the time to calculate the cost. There are various calculators available on the internet to help with the cost analysis. Account for co-pays, premiums (the monthly cost that you pay your insurance company each month), and co-insurance.
7. Consider Previous Problems
If you had a significant issue with a health insurance provider in the past, think ahead. How can you prevent this issue from incurring next time? Do you receive a specialty service that is not typically provided? If so, ask before you commit. Call potential insurance providers and seek assistance. Be ready to provide procedure codes so they can assist you properly.