How To Choose A Health Plan That Is Right For You

Choosing the right health plan can be confusing and overwhelming. There are multiple options available, all with different levels of coverage, copayments and deductibles. Finding the best plan depends on individual needs, how much one can afford and participating providers.

What Type of Plan Should You Select?

Before reviewing any details, choosing which type of plan you want can narrow down the field of options. A health maintenance organization (HMO) usually requires a primary care physician to be the first point of contact for all issues and they will refer patients out for tests and specialists. Providers need to be part of the network for benefits to be paid. A preferred provider organization (PPO) does not require referrals and any doctor can be seen as long as they are in the network. Doctors and specialists out of the network can still be seen but may be billed differently.

What Benefits are Included?

After deciding on an HMO or PPO, carefully consider the benefits associated with the plan. All plans generally cover hospital and doctor visits in some capacity, but benefits like prescriptions, mental health and vision are not standard benefits. The first step to determining if a plan suits your needs is to make a list of the services and providers that you and your family use most often. This list will help you compare the different plans available so you can find one that has all the services you and your family need.

Know the Costs

Cost is a major deciding factor for many families choosing a plan. In addition to monthly or annual premiums, many plans have deductibles and copayments that can vary extensively. When budgeting for a health plan, remember to account for all out of pocket expenses, not just the premium. A less expensive insurance premium may cost you thousands of dollars a year in deductible and pharmacy costs.

In Network or Out?

The providers that are part of a plans network can also influence the cost and suitability of the benefits. If you currently use specific doctors and hospitals, make sure they are part of the network you are joining. If they are not, be willing to change providers.

Buy with Confidence

Before purchasing any insurance, be sure to check out the company you are purchasing from. Read reviews and surveys to get positive and negative feedback. You can also check with the state insurance departments for any relevant information. Talk with representatives from the company and review all of the plan documents before signing up. Make sure you have all of your questions answered before making a commitment. Also review cancellation policies as well as any additional fees.

Choosing a health insurance for yourself and your family is an extremely important decision. Review all of the facts, costs and benefits carefully before making a decision. Look for advice and information from a variety of sources including doctors, family and friends, unions, websites and employers. Making an informed and confident decision will ensure the best benefits to suit your needs.