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Step by Step Guide to Choosing a Health Insurance Plan

Step by Step Guide to Choosing a Health Insurance Plan

Picking the wrong insurance plan for you and your household could come with grave consequences. As a result, we hope that this article will hold your hands and guide you towards making the right health insurance decision

Chose Your health Plan Marketplace 

Many people get their health insurance via their employer. People in this category do not need to use government insurance marketplace since their company is the marketplace. 

You can, however, consider an alternative plan in the exchange. These plans will likely be more costly because many employers subsidize worker's insurance premiums by paying some part.  

If your job, however, does not come with health insurance benefits, you could examine the federal or state marketplace to get the lowest premium. There is also the possibility of getting health insurance straight from the insurer. This option will, however, disqualify you from premium tax credits

Compare the Available health Insurance Plans 

In shopping for health insurance, you will likely come across policies like POS, PPOs, HMOs, and EPOs. The type you go for determines your cost and the type of doctor available to you.

The best way to determine which plan to go for is to examine the benefits. You will have access to this via a link in the online market place. You should also be able to get access to the type of doctors and clinics available 

In examining the plans available, your family's medical needs should be the deciding factors. The kind of treatment and cost you have received before should guide you. While you might not be able to predict medical expenses, a trend will help you make the right decision.

Compare Health Plan Networks 

An in-network doctor will be less costly because insurance companies do agree on a lower rate with in-network providers. Going out of network, on the other hand, could subject you to higher rates since the doctors do not operate based on a specific rate.

Should you have doctors you want, and you prefer to keep seeing them, be sure the provider directory you are in covers them.

In the absence of a preferred doctor, consider a plan with a vast network that gives you more choices. This is preferable for people living in rural settlements since there will be a high probability of getting a doctor that will work with your plan.

Compare Out-of-Pocket Costs 

The summary of the benefits of the plan should state your charges for out of pocket services. The federal marketplace, alongside many states, offers this cost comparison.

This is why you need to be familiar with some health insurance terms. Your cost portion as the consumer involves coinsurance, deductible, and copayments. The entire amount you can spend out of pocket for a particular year is limited. During this step, your goal should be to streamline your choices depending on out-of-pocket costs. You can only consider a plan that pays you a higher portion of your medical bills if:

  • There is surgery on the way
  • You need emergency care often 
  • You have kids, you plan to have kids, or you are pregnant
  • You take expensive medications often

On the other hand, you can consider a plan with a higher out-of-pocket cost, and reduced monthly premium provided:

  • You rarely see the doctor
  • Your health is superb

Compare Benefits 

I believe you already have your options reduced to a few. To further streamline what you have, consider the summary of benefits and let that be the deciding factor. There could be plans with better coverage for services like mental health care, physical therapy, fertility treatment, etc. 

Avoid skipping this step as it could prevent you from missing a plan that will be well suited for you and your household. With a couple of options remaining, you could address any questions you have. It might help to speak with professionals; in this case, the plan's customer service lines.

Here are some questions you should consider asking. Write them down and have them handy before making the call.

  • I take some medications. Is this covered under the plan?
  • For my conditions, is there any drug covered in this plan?
  • Is there any provision if I am sick while abroad?
  • Is there any particular process to sign up?
  • What documents will I need? 
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