Choosing a health insurance plan can seem like an overwhelming task. For individuals or families who want to have adequate coverage without paying too much for their plan, the decision of which plan to choose isn't always an easy one to make.
It's best to review each plan's summary of benefits and coverage as well as talking to the insurer for more specific and individualized needs. However, there are five factors to keep in mind when choosing a health insurance plan to avoid missing important information.
Most people probably have certain healthcare providers, hospitals, and pharmacies that they prefer. Consider whether the plan covers those preferences or if you would need to change doctors. In-network service are going to be covered under a plan while any out-of-network services may result in higher costs or even not be covered at all. Check to see if your preferred provider and pharmacy are included in network or if you would need to make a change.
The cost that you pay for health insurance monthly is called the premium. You have this cost even if you don't use medical or pharmacy services. If you stop making them at any point, you will lose your coverage. Keep in mind that this is only part of your medical costs. You'll also have to pay or deductibles and cost sharing. For example, most plans do have a co-payment that is due every time you see a doctor. Make sure that you can afford the premium and the co-pay.
This is the amount of money that you pay before your coverage kicks in. For example, if your plan has a $1,000 deductible, then your plan won't pay for most of your healthcare expenses until you've spent $1,000 on expenses out-of-pocket. These costs may include specialist visits, fees for certain procedures, and possibly even prescriptions. A higher deductible will result in a lower monthly cost and vice versa.
You should also be aware that there may be additional costs that you'll have to pay in order to access care. You may be responsible for other expenses even after meeting your deductible. For example, some insurances have a co-pay which is a flat fee that you have to pay even for covered services. Review these to ensure that you can afford them.
If you have any current prescriptions, you'll probably also want them to be covered under your insurance plan. Each insurer will have a formulary, which is a list of medications that are covered by the plan. If a medication is not listed, then it may not be covered, causing a high cost to yourself or possibly a long process needed to obtain coverage. Make a list of any medications you need to be covered and review. These five factors are going to help you to determine which healthcare plan is right for your needs. Use this guide to get good coverage and keep yourself and your family safe.
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