Hassle-Free Health Coverage: What You Will Pay
As we discussed earlier, your health insurance won't cover you for everything. If you opt for a reimbursement-style program, you'll also have to choose a deductible and at other times you'll have to pay a copayment.
In order to get a true idea of what your costs will be under each plan, you need to look at how much you will pay for your premium and other costs. You can't possible know what your health care needs for the coming year will be, but you can guess what services you and your family might need.
To figure out what the total costs to you and your
family would be for services under each plan, it makes sense to ask the following questions:
- Are there deductibles you pay before the insurance begins to cover your costs?
- After you have met your deductible, what portion of your costs are paid by the plan?
- Does this amount vary by the type of service, doctor or health facility used?
- Are there copayments you must pay for certain services, such as doctor visits?
- If you use doctors outside a plan's network, how much more will you pay?
- If a plan does not cover certain services or care that you think you will need, how much will you have to pay?
- Are there any limits to how much you must pay in case of major illness?
- Is there a limit on how much the plan will pay for your care in a year or over a lifetime? (A single hospital stay for a serious condition could cost hundreds of thousands of dollars.)
Some people choose a deductible in the thousands of dollars making theirs, in essence, a catastrophic insurance policy. In this case, you'd absorb all the everyday costs of medical care, from doctors visits to prescriptions. But, if you got seriously ill, you'd be covered. If you are single and healthy, this could wind up saving you money.
For most people, a deductible in the $100 to $250 range is easiest to live with. But look into other deductibles, too. If your family has been healthy for a number of years, you may want to switch to a deductible of $500 or $1,000. You'll notice a sizable reduction in premiums. (Just remember that you'll have to pay your own way until you satisfy the deductible.)
You'll also want to investigate what the insurance company considers usual, reasonable and customary charges, if at all possible.
That's because the charges a company considers normal for a particular medical procedure in a specific geographic area are the maximum it will pay. If the charges are higher, you'll be stuck paying the difference.
Another way you can save money on your premiums is by paying them annually. It's worth looking into how much the service fee is for monthly payments and inquiring about a discount for prepayment.
Even if you don't get to choose the health plan yourself (for example, your employer may select the plan for your company), you still need to understand what kind of protection your health plan provides.
The more you learn, the more easily you'll be able to decide what fits your personal needs and budget.
