Not everyone needs the same medical insurance. That’s obvious. The question then becomes, “What’s the best health insurance choice for me?” Before you go looking for health insurance quotes, here are five ways to narrow your search.
Plan design and availability vary by state. Find out which ones are available where you live.
Take a few minutes to consider what lane of the medical insurance market you should be looking in.
See if your doctor or preferred hospital is included, if that matters to you.
You save money and might pay less out of pocket by staying in-network. Choose doctors or facilities within the health plan network. Using the network is easier if you’ve checked that the places you generally get care are part of the network. If not, are there network alternatives you can live with?
Even medical insurance plans of the same type with similar kinds of coverage can be different in the details. Match competing health care plans in terms of benefits and limitations that are important to you.
Brace yourself for this – even with medical insurance, you’re still going to have costs to pay out of your own pocket. Here’s your cheat sheet. Look for these five terms to get an idea what you’ll be paying during a year with a given health plan.
Premium – What you pay (usually monthly) to have medical insurance.
Deductible – What you must pay for expenses covered by your health plan before the insurance company will pay.
Copay – A set dollar amount you have to pay to receive certain services, like $30 for a doctor office visit.
Coinsurance – The percentage you pay of covered medical expenses after you’ve met your deductible, often 20% to 30%. That means every $20 to $30 out of $100 is yours to cover even after you meet your deductible.
Out-of-pocket maximum (or out-of-pocket limit) – The most you pay during the term of the health plan toward covered expenses.
Generally speaking, premium payments and copays don’t count toward your deductible.
Hospital and doctor fixed indemnity plans1 pay a set amount of money after you receive specific covered medical services. Regardless of other insurance coverage, these plans pay cash once a covered expense is submitted for some of the most common medical situations you’re likely to face: surgeries, trips to urgent care or the ER, a visit to the doctor for the cold you can’t shake.
As a companion to your medical insurance, a hospital and doctor plan can help you deal with costs like deductibles and copays that your main insurance doesn’t cover.
No matter how good it is, no medical insurance plan is going to cover everything. You can fill in the areas you need with additional plans.
With supplemental health plans like these and others, you have more freedom to build up coverage in areas where you feel the need.
Certainly, these five steps aren’t the only areas to consider when deciding where to buy health insurance. But they are a simple way to help you focus in on your needs and eliminate health care plans that aren’t worth your time or might not be the right fit.
1THIS PLAN PROVIDES LIMITED BENEFITS. This is a supplement to health insurance and is not a substitute for the minimum essential coverage required by the Affordable Care Act (ACA). Lack of major medical coverage (or other minimum essential coverage) may result in an additional payment with your taxes.