Because of various types of health insurance plan, people often confuse when they have to choose health plan for themselves and their families. Most people often think that expensive health plan is better than the cheap ones. Therefore, there are many people who pay the health plan that actually unnecessary if it is looked from their health care needs.
Are you looking for health plan, but you doesn’t have enough times to do the research? Here are few tips to help you choosing the right health insurance plans. Have a look.
Ask your doctors
Each insurance plan has the list of what they call the in-network doctors and providers. The insurers would help paying the health care cost only if you visit their in-network doctors or providers. Other than that, you have to pay full by yourself. That is why, you should ask your health care providers in what health plan they are included.
Affordable Care Act (ACA) which controls health insurance quality and affordability stated that all health insurance plan should cover preventive care fees of their clients with one condition that the preventive care should be done by the in-network providers. If you go to doctor that is included in out-of-network list, you will lose your right to get free preventive care. Visiting out-of-network doctors also lead you to paying higher deductible (the required amount you have to pay before the insurers would cover your medical expenses) and out-of-pocket maximum (the maximum amount you can pay for the medical expenses in one year. If the expenses are more than out-of-pocket maximum, the insurer will pay the remaining cost).
Consider the deductible amount
When you choose health plan, basically there are four items you have to pay, premium, deductible, copay and coinsurance. Premium is the amount fee you have to pay each month. Copay is flat fee for each time you get health care service. Coinsurance is the percentage amount you have to pay for medical expenses. Usually coinsurance requires you to pay 20% out of total health care cost. The higher deductible you choose, the lower premium you will have to pay per month.
To get the right health plan, it is recommended to see your last-year deductible. If last year you didn’t reach your deductible, it means your health care needs are so low that it doesn’t matter you didn’t reach deductible. So, it will be good if you choose the higher deductible for this year to save your premium cost. On the opposite way, if you reached deductible last year, it is recommended to choose lower deductible last year.
Coverage for medicines
Check the formulary in the health plan. Formulary is the list of medicines that insurers would help paying off.
- Generic drugs. Generic drugs usually are included in the health plan. These drugs have cheap price. You don’t have to pay much for generic drugs.
- Brand-name drugs included in formulary. The drug companies are partnered with your health insurance company, so the drugs’ prices are lower than usual prices.
- Brand-name drugs not included in formulary. Since your health insurance company don’t have agreement with the drugs companies, you will pay more in order to get the drugs.
When you choose health plan, besides checking the formulary, don’t forget to check the copay and coinsurance for the prescription drugs you need.