How to Choose Health Insurance
The best health insurance is there for you when you need it most. Decide your policy based on your current healthcare concerns and budget.
Employer-sponsored health insurance programs are declining. In the past few decades, the number of people covered by their employer’s healthcare benefits dropped from 75 to 68 percent.
This means more and more employees are responsible for covering their own healthcare costs. Make sure you have access to the coverage you need by reviewing this guide on how to choose health insurance.
An insurance premium is the fixed monthly amount paid to get an insurance policy. Premiums are paid directly to insurers usually through automatic payments.
Usually, paying a higher premium means getting more coverage, but there are other factors that influence the amount you pay. Lower premiums almost always mean minimal coverage and potentially not getting access to the services you want.
When shopping for healthcare insurance, you’ll have to balance your budget with getting the care you need. Avoid any policies that make you pay for a range of services you’ll never use.
If your income is between 100 and 400 percent of the federal poverty level, you might be eligible for a subsidy through Healthcare.gov. The subsidy comes in the form of a premium tax credit that makes your monthly premium amount lower.
The healthcare marketplace offers a free online calculator to help you determine whether you qualify for a tax credit.
Deductibles are another important cost to consider when choosing a healthcare plan. It’s the amount you pay before the health plan pays your medical bills.
Most policies require you to pay all of your costs until you reach the amount of your deductible. But there can be exceptions to this rule like when you get a health exam with your primary care doctor.
The policy you choose will specify which healthcare expenses count toward meeting the deductible and which don’t. You can pay $500 for an elective procedure that’s not covered by your insurance and it won’t count toward your deductible.
Policies with lower deductibles often have higher premiums because insurers begin paying your medical expenses sooner than they would with a high deductible. The cost comes back to you in the form of increased premium payment.
Diverse Network of Doctors
Choosing a plan that includes a diverse network of doctors is important in getting flexible care. Doctors who are out of network won’t count towards your deductible and may not be covered at all by your health plan.
The insurer you choose has existing relationships with healthcare providers who agree to meet their terms and conditions for payment. These are the providers who are considered ‘in-network.’
Most health plans post a directory of in-network providers on their websites so you can easily access doctors in your area. Review these directories before making a final decision on a plan to make sure there are enough doctors in your area to meet your medical needs.
For example, if you have children, access to a children’s hospital might be important. Or with aging parents, oncology centers nearby can provide access to cancer treatment if anyone falls ill.
You want a strong and diverse range of healthcare providers in the insurance company’s network who can address any concerns your family might have.
What If I Already Have a Doctor?
Choosing a new insurer doesn’t always mean you have to switch doctors. Choosing a plan that offers out of network care is usually the best solution if you want to keep the provider you have.
These plans agree to pay some of the medical bills for out of network care. The amount paid varies by plan, but it’s much better than paying the bill on your own.
At some point, you’ll need access to a doctor who is out of network because no plan can account for every medical situation. Even within an in-network hospital, not all specialists are part of your insurer’s network.
A policy without network coverage helps to protect you against unexpected costs when you have an emergency.
When Can I Enroll?
Open enrollment for health insurance is usually at the end of each year. For 2020, the period went from November 1, 2019, to December 15, 2019.
During this time, you can sign up for new health plans for yourself or your entire family. These dates vary from year to year but are usually during the 4th quarter so you are covered when the new year begins.
It is possible to enroll outside of the standard open enrollment period if you experience a major lifestyle change. For example, getting married or having a baby are two major changes to your family that allow you to enroll in a new insurance plan.
If you need Medicaid or CHIP, the Children’s Health Insurance Program, you can always enroll no matter the time of year.
What Insurance Plans Can I Choose From?
Now that you have the basics of how to choose health insurance, you’ll need to select a provider. Provider options vary based on where you live.
For example, if you live in the state of Texas, you’ll have access to a wide range of providers like Aetna and United Health Care. But in Utah, health insurance provider options are far more limited.
In addition to traditional health plans, you can apply for alternative coverage that pays for things like cancer treatments or accidents. Alternative healthcare plans come with a lot of limits but provide some benefits if you need a temporary healthcare solution.
The key to choosing a health plan that makes sense for your lifestyle is reading the fine print. During and after a hospital visit isn’t the time to learn out of pocket costs for treatment.
Shop smart by working with a knowledgeable consultant who can help you navigate insurance plans in your state. For more information or to get an insurance quote, contact us today.