Health Insurance Plan - Things to Consider When Choosing One
Posted on December 28th, 2007 in Health Insurance |
Do you know what things to consider in choosing a good health insurance plan? With so many different options, it can be difficult to know just what to look for. But the number one thing to remember when you are choosing a good health insurance plan is that your decision should never be based solely on the cost of the monthly premium. You must read the details of the health insurance plan including what it does and does not cover, the in-network versus the out-of-network coverage and costs, the co-payment amounts, the deductible amount (per family member, if applicable), and the coverage caps.
The first step in understanding what to look for is to get an understanding of your particular needs. Are you looking for coverage for just yourself, yourself and your spouse, yourself and one child, or do you need a family plan? This is a fairly straight-forward issue. Next try to assess the health needs for all those you intend to include on your health insurance plan. This is a bit trickier. Are you and the others basically in good health? Are there any pre-existing conditions to consider? Is there a particular need to have access to certain medical specialists or medical institutions?
Knowing the answers to the above questions will give you a good starting point when deciding what to look for when choosing a good health insurance plan. Next, you need to know about your options. If you are getting group insurance through your employer, your options will be limited to what the company is offering, which may or may not make this decision easier. At a minimum, you have got to understand the difference between an Indemnity Plan and a Managed Care Plan and its variants, which are the two basic types of health insurance plans offered today.
Basically, an Indemnity Plan offers participants the freedom to choose when and where they will seek medical assistance. Along with this freedom usually comes higher out-of-pocket costs, but for many it is a fair trade-off. Managed Care Plans are more restrictive, and require participants to utilize the medical professionals and institutions that are part of the plan’s ‘network.’ Participants often need pre-approval for medical services that are beyond basic preventative care. The costs are usually lower than Indemnity Plans and for those who are basically healthy, don’t particularly care who provides their medical services, and who need to keep an eye on medical costs, Managed Care Plans are usually the better choice. This is a very basic comparison of the types of health insurance plans, and further investigation into the details is advised.
Once you think you have got it all figured out, do you know how to choose the right health insurance company? Many companies today offer health insurance, from the well-known corporate giants that have been in the business for years to the small, independent outlets. As with any major purchase, you have got to research these companies before making a final decision. Ask around, use the Internet, and try to understand their claims filing procedures. This will give you the information you need to help you choose the right health insurance company.
What to Look For in Choosing Your Health Insurance Plan
Health insurance plans have become very complicated in recent years. In the days of the old “traditional” plans, you had to pay your monthly premium and your annual deductible and that was all you needed to know about. Today, the different options available are mind-boggling. Just looking at the cost of the monthly premium can no longer be the basis for your decision about health insurance. You have to understand all of the various features such as in network, out of network, how much the doctor co-pay will be, different levels of deductibles and perhaps even caps on coverage.
The decision for a health insurance plan therefore has to be very individualized. First, of course, do you need single, parent and child, husband and wife or full family coverage? Do you and your family visit the doctor infrequently so you don’t mind paying a higher doctor co-pay in order to have lower premiums? Do you or someone in your family have a condition where you have to go to a certain specialist or to a certain hospital? If so, you will have to have a plan that allows out of network coverage.
Those are the main starting points when you are considering your choice of health insurance plans. Next, what options are available to you? If you are taking advantage of an employer sponsored plan, you may not have too much choice, just the options your employer offers. Your employer may offer two options, an indemnity plan, the older kind where you have a deductible and pay for everything until you reach your deductible, or a managed care plan where you pay a small co-pay, but have limitations as to services and service providers.
An indemnity plan let you go to the doctor of your choice, and usually your out of pocket expenses will be fairly high. If this is a feature that is important to you, you may find it worth the extra cost. A managed care plan puts a lot of restrictions and you have to be careful to abide by them or you may find that you are not covered for the medial services you had. You have to stay within the network of the plan’s doctors, you will have to be pre-approved for certain procedures, and you may need referrals for specialists. These restrictions keep the overall cost of the plan lower. If you and your family are healthy and there are no special needs that would require going to a certain doctor, this is a perfect plan to keep your medical costs low. Just remember, that this is a quick explanation of the basic types of plans, and you need to do further study to make your decision.
Now that you understand the differences between types of plans, you have the added burden of deciding which is the right insurance company for you. Most of the health insurance companies offer all of the different types of insurance. There are big, nationwide and well known health insurance companies, and there are smaller independent companies. Do as much research as you can; take advantage of the internet, ask friends and relatives who they use and if they are happy with their choice and their claims experiences. All of this information will help you make the right choice for your health insurance company.
Michael Benifez reports for http://www.LifeinPalmCoast.com, covering world of finance, mortgage loans, refiancing and insurance in Palm Coast, Florida and Flagler county. His latest article on Flagler county Florida health insurance covers health care options.