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Top 7 Things You Need to Know When Buying Health Insurance

The Top 7 Things You Need to Know When Buying Health Insurance

Shopping for health insurance can be quite confusing. Simply deciding on the right type of insurance for your family can be an arduous process. Once you have chosen a type of insurance, there are still many more choices to be made. The market is glutted with available options, all with their own pros and cons. A checklist of what to look for can be helpful in sorting through the choices.

#1. Which type of insurance do you want? Traditional insurance generally carries a lower monthly premium, but your portion of the bill is much higher than you will find with managed care. HMOs allow you to see a doctor for a minimal co-payment, but require a referral from your primary care physician to see a specialist, and require you to see doctors who are in the network. PPOs are similar to HMOs, but allow you to go out of network on a fee schedule similar to that of traditional insurance. Make sure you know which type of insurance will best meet your family?s needs.

#2. If purchasing traditional insurance, how high do you want your deductible to be? The deductible is the cost you will pay out of pocket before the insurance begins to pay. As with car insurance, the higher your deductible, the lower your monthly payment will be. Remember that once your deductible is met, you will still be responsible for 20% of your medical bills.

#3. If joining an HMO, which doctors and hospitals are members of the network? If you already have a primary care physician, is he or she a member of the network? How close to your home is the nearest in-network hospital? These issues are less important under a PPO, since you retain the right to go out of network, but remember that out of network rates are significantly higher than in-network rates. Therefore, even under a PPO you should be fairly comfortable with the available network.

#4. What are the limitations on pre-existing conditions, and what exactly constitutes a pre-existing condition? Some plans simply refuse to cover any pre-existing conditions. Others have a waiting period before coverage will begin. Often a condition for which you were treated more than 12 months prior to the beginning of coverage, that recurs after coverage is in effect, will be covered, but this is by no means standard policy.

#5. If you are insuring a female, is maternity care covered? Some plans simply do not cover maternity, others offer maternity coverage as an upgrade, and others will not cover pregnancies that occur within the first 12 months of coverage.

#6. What is the policy on rate increases and coverage drops? Some plans will drop your coverage if you are diagnosed with certain life-threatening illnesses. Others will continue to cover you, but raise your rates dramatically. Other plans will not single you out for rate increases, but may raise rates drastically across the board, either annually or randomly. Be sure that you understand how rate increases and coverage drops are handled.

#7. Are prescription, dental, and vision plans available? Normally, health insurance does not cover these items. However, many plans offer partnership agreements with providers of those services. It is not necessary, as all three can be purchased independently, but when trying to decide between two similar health plans, this is a nice perk.

When purchasing health insurance, it is important that you look past the initial numbers. A plan that appears perfect for you may not turn out to be such a great deal. Alternatively, a plan that seems highly expensive may provide solid and reliable coverage no matter what life brings your way. Asking at least these seven questions will help you to make the right choice for your family. Take your time and think it through so you can sleep soundly at night knowing you are properly covered

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