Health Insurance | Finding the Perfect Fit

Health Insurance Online | April 26, 2013

Be aware of the different options of your health insurance plan, it can save you money in the end.

Shopping for health insurance coverage can get overwhelming given the slew of options available to American consumers. While most already have health coverage from their employers, many others still do not have health insurance. With the passage of the 2010 Patient Protection and Affordable Care Act, they may need to obtain coverage or face a penalty. That’s why purchasing health coverage is in everyone’s best interest.

The first thing you have to consider is what you must have protection against. Injury and illness is a given, as you cannot foretell when these two can befall you. For women, maternity coverage is equally important, even if you’re single and not all insurance providers cover it. If your medical history makes you a possible candidate for diabetes or heart disease, get a plan that covers medical screening for these diseases and other chronic disease like them. The Affordable Care Act of 2010 requires health insurance providers to cover over two dozen preventive care services, including vaccinations, screenings for cholesterol, blood pressure, some forms of cancer, and diabetes.

Try not to “overbuy” health coverage. If you are healthy and strong, you may want to consider increasing your deductible so that you can pay a lower premium. The deductible is that part of the policy which the insured would have to pay out of their pockets. Younger and healthier individuals are not expected to avail of medical services that much so it may be wise to stick to a lower premium and a higher deductible. A high deductible plan would start at $1,000 deductible, and this can save you on premium costs.

Check the health care network in your area. Particularly, you want to make sure that your favorite doctor is part of this network so that you can continue going to them under your insurance policy. Your insurer will have a lower share of the costs if you opt to go out of the network to get medical care. Insurance companies will provide you with a directory of the doctors, hospitals, clinics, and other health care providers included in their network.

Make sure you know your out-of-pocket costs, or the share that will come from your funds in the insurance policy. If you have no idea what a deductible, co-insurance, co-payment, and out-of-pocket maximum is, you should research it first or, better yet, have your agent explain them to you. These terms comprise the portion of the cost of your health care which you will pay for. When you have a minor ailment, the co-pays seem to be small and manageable but they do pile up. And when the time comes when you need to undergo a major medical procedure, you might end up with a share that could be in the thousands of dollars.

Before signing up with any health insurance provider, check their list of formulary. This list contains all the drugs that they cover in the prescription plan. You need to make sure that your drugs are part of this list so you don’t have to pay for them anymore.

At the moment, all health insurance policies come with annual limits, but come 2014 there will no longer be annual limits on all plans and this is thanks to the health reform act. There will still be annual limits for medical services that are not deemed essential. There will be cases when the plan provider would need to obtain a waiver for procedures that they wish to maintain the annual limit on.

If you have children, the health reform law provides that they can be covered under your employer-sponsored health care plan until the age of 26, unless they too have coverage from their employer. Health plans cannot exclude children under the age of 19 from health coverage due to pre-existing conditions. Make sure you are aware of the mechanics of covering your dependents as these underwent major changes when the health reform law was passed.

If you do not have an employer-sponsored health care plan, and would like to obtain health insurance on your own, make sure you consider a number of plans. It really isn’t that hard to understand the plan features offered by different health insurance providers. You can go to the Internet and have a program compute your premium based on your personal circumstances. Just make sure you are comparing apples to apples, meaning the levels of coverage are all the same.

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