What are the key points that I must consider in evaluating health insurance plans?
After you have done your research, compare the health insurance plans that you consider buying to several others and also to what your health insurance needs are. Which aspects of the plan do you think are important to you? Which provisions do you think should be prioritized? To evaluate health insurance plans, you need to compare their deductible amounts, coinsurance, cost of office visits, coverage for prescribed medications, maximum out-of-pocket amounts, savings account provisions, pre-existing conditions clauses, other aspects that the plan covers, and services. Deductibles are the amounts you pay to the doctors and hospitals before the health insurance company pays for their services. This means that if you got into an accident, you will have to pay the deductibles first before the health insurance plan will cover the other medical services that you will have. Deductible amounts are set every year that you are covered by the health insurance plan. So if you often get sick, it might be better if you get health insurance plans that have low deductibles. Otherwise, if you are generally healthy, it might be best if you get a plan that has a high deductible. Coinsurance is part of the medical bill that you need to shoulder. This is required by the insurance company. Usually, this is also required even after you have met your deductible amounts. For example, your coinsurance amount is $20, while your total medical bill is $100. You will only pay $20 and the health insurance plan will pay the remaining $80. You can also compare the costs of office visits among the health insurance plans that you have short-listed. How much will a visit to primary care physician cost as compared to a specialist? The difference in the rates can help you choose the plan that will fit your needs for doctors’ visits. Prescription coverage may also be used as a point of comparison among health insurance plans. Some health insurance plans shoulder only the cost of generic drugs rather than those with brand names. Some plans cover both. For health insurance plans that cover both generic and branded drugs, try to check which type of drug the plan will shoulder most – the generic drugs or those with brand names? If you are often sick and is often on prescribed medications, try to check if the medicines are available in generic form, and if your doctor is willing to prescribe them. This is usually the best action to take if you prefer a plan that will only pay for generic drugs. Out-of-pocket amounts include the amounts for copayments, deductibles and coinsurance. These are the amounts you pay before your medical expenses are shouldered by the health insurance plan. The out-of-pocket amounts are set at a maximum level per year or per lifetime. If you are generally healthy, then the out-of-pocket amounts may not be too much of a concern for you. Today, health insurance plans can be accompanied with healthcare savings accounts. These saving accounts allow you to save money to pay for your deductibles and coinsurance. You may be able to attach the savings account to your health insurance plan, but be sure to you might inquire about penalties and benefits. Pre-existing conditions are also an important point when comparing health insurance plans. Pre-existing conditions are health conditions that have been diagnosed before you bought the insurance plan. Most often, health insurance plans do not include pre-existing conditions as part of their coverage. Other points to consider when evaluating health insurance plans include out-of-network coverage, out-of-country coverage, hospital services, maternity coverage, and outpatient services. For out-of-network coverage, check the provisions of the health insurance plans that you have short-listed if you can still use the services of the doctors and specialists that do not belong in their network of healthcare providers. You can also check their provisions for out-of-country coverage in case you travel a lot and you experience emergencies in other countries. The health insurance plans’ provisions for hospital services must also be evaluated. The fees of hospital staff usually have separate provisions and might not be included in your standard healthcare coverage. You might also want to check the provisions of the health insurance plans regarding prenatal visits to specialists, and other hospital services that are maternity-related. Check also if the plan will pay for the X-rays, laboratory exams, outpatient surgeries, and other outpatient services. Answer by Moderator - June 19, 2009 @ 5:16 pm No CommentsNo comments yet. Leave a comment |
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In assessing the health insurance plans that you think are best for you, you need to do your research. You can do your research on several private health insurance plans, or those that are offered through your employer.
