Choosing the right health insurance can be a balancing act that ultimately falls somewhere in the middle, between affordable monthly premiums and the right personal or family health coverage. Here’s how to check out various options and find a suitable plan Billing Specialist Salary.
Assess your health situation when choosing health insurance
If you are young and in good health, your insurance needs may not be as great as those of an older person, someone with a chronic illness, or someone who takes medication every day.
Help predict medical costs for the next year by looking at your health care use from the previous year. “Calculating your health care budget is like running a family budget.
Get the Explanation of Benefits from the previous year or contact your health care or insurance plan providers for a list of all doctor visits, tests, medications, and any other health care expenses. Then separate those expenses between copays, coinsurance costs, non-covered services, and charges applied to your deductible. This will allow you to see where you spent the most money and where you will need to increase your coverage in the future.
For example, if you’ve been to the doctor multiple times in the past year, a plan with lower office visit copayments may work for you. If you have an illness that requires expensive tests, surgical procedures, or hospital stays, buy a plan that lowers your coinsurance and deductible for those services.
If you take prescription drugs regularly, be sure to read the plan’s prescription drug policy. “Many people don’t know that separate deductibles may apply for prescription drugs,” says Jackson. Drug costs can go up, especially if you can’t take a generic substitute and your plan doesn’t cover certain brands.
Also, if you are planning a pregnancy or surgery, factor those expenses into the equation.
Understand the different types of health insurance plans
One way to keep insurance costs down is by restricting your choice of providers. No one wants to be told that you cannot visit the doctor of your choice, but this option (known as managed care) still offers quality care.
The main option for managed care is the health maintenance organization (HMO) plan, the most controlled type of plan with the lowest premiums and coinsurance.
In comparison, Preferred Provider Organization (PPO) plans cost more per month but offer great flexibility by allowing visits with doctors outside of the plan’s network.
While it is not a health insurance plan, another option that allows you to pay for medical expenses is a health savings account (HSA). To qualify for this account, you must be enrolled in a high deductible health plan. Although this option has a high deductible, the money contributed to the account is not subject to income tax when it is deposited.
Your willingness to understand and follow the restrictions in your plan will determine which type of plan is right for you.
Compare Premium and Health Care Coverage Options
If you are shopping for insurance in the new health insurance exchange (also known as the Marketplace), you will see the plans grouped into five categories: Platinum, Gold, Silver, Bronze, and Catastrophic. This system encompasses the various factors that control plan coverage and cost levels, such as premiums, copays, coinsurance, deductibles, and out-of-pocket maximums, and allows you to compare plans overall.
Even if you use this part of the site, compare the details of each health plan yourself to match your specific needs.
Evaluate the possibility of supplemental health insurance
Depending on your situation, you may want to expand your insurance coverage. Guaranteed Automatic Protection (GAP) and Hospital Indemnity insurance plans can protect you in the event of a catastrophic illness when you’re usual coverage falls short. However, make sure you know what this plan does and does not cover.
“They are not intended to replace major health insurance plans,” says Jackson. Also, when combined with a Bronze level plan, they can provide a higher level of protection at a much lower cost than the next level of coverage.
If you are unsure about your options or if you need additional advice, a certified insurance agent can help you assess your needs and compare a wide variety of health insurance plans to find the coverage you need at the price you can afford.