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6 Important Factors to Consider When Choosing Health Insurance


By Allen Brown

We all need health insurance if we want to avoid paying a fortune every time we have a medical issue. Understand though, that shopping for health insurance is a massive task that requires a good amount of time to do right.

Health insurance is important not only for the sake of you and your family’s health, but also to help save money. It's important to know, as well, that there are some healthcare facilities and doctor's offices that will not treat you if you don’t have health insurance, or if you don't have the health insurance plan they accept.

There are hundreds of insurance companies, all with health insurance plans that you can choose from. It is impossible to scrutinize all of them, so it helps to know what you want before going shopping for health insurance.

The following are six important factors to consider when choosing health insurance:

1. Plan and Provider Network

As mentioned, there are many health insurance plans available right now. You should first consider what you need covered in a healthcare plan, and then go about searching for the one that can cover those needs best.

To start, make sure to check if the healthcare plan you're looking at is accepted by your current healthcare provider, hospital and pharmacy. If they are not, you will either have to change your insurance plan or change your healthcare providers.

Also, seriously evaluate how the prospective insurance provider handles settlements. Reading customer reviews is a fantastic way to learn from other's experiences on how the insurance provider deals with customers.

2. Deductibles

There are many costs that a health plan might not pay up front until after you have paid for certain costs, such as consultation fees, certain prescriptions, or sometimes so many visits to a specialist. These costs are called deductibles.

The deductible of a healthcare plan refers to how much you have to pay out of pocket before the insurance coverage is activated. For example, if your health plan has a $500 deductible, it means that the plan will pay for any expenses, or a percentage of the expenses, you incur above $500.

You should check the health care plan to see if it has a single or combined deductible. It will have a significant impact on your premiums, which leads to the next point.

3. Premiums

The premium is what you pay the insurance company for the health plan. It is typically paid monthly, but it will depend on your agreement with the insurance company.

There are many costs associated with health insurance coverage. The more the supplementary benefits, the higher the premium. The premiums are by far the largest cost of a health care plan.

You will have to pay the premiums whether or not you utilize the healthcare plan. However, if you stop making premium payments, then you will lose your coverage.

If you choose a healthcare plan with high deductibles, then you will pay lower premiums, and vice versa.

4. Medicine Coverage

Medical prescriptions are the largest expense for most people’s healthcare plans. Therefore, make sure to consider whether it is included in your plan, and how much is covered.

Each insurance provider will probably have a list of medicines that the plan covers, called a formulary. If you are to obtain a medicine that is not in the formulary, then you will have to pay for it out of pocket.

In considering various health insurance plans, it would be helpful to make a list of the current medicines that you are currently taking, and make sure your list is comprehensive. When considering your insurance company, make sure as many medicines in your prescriptions are included in the formulary, or at least the most expensive ones.

5. Co-pay or Co-insurance

Getting healthcare insurance is an assurance that you will have access to healthcare. However, there are many other costs associated with a healthcare plan that you should know.

Co-pay refers to the flat fees that you have to pay for covered services or prescriptions. Co-insurance is the percentage of medical bills that you must pay for medicine or certain services.

You should always remember that you may be liable to pay for other costs even after you reach your healthcare plan’s deductible. Be sure to ask about these costs as they can be significant, and thus, very important to consider.

6. Additional Benefits

There are obvious services that the healthcare plan will clearly tell you about and outline in 'black and white'. However, there may be other additional benefits that may not be as apparent.

You should ask about these peripheral benefits, and find out what is covered, and what they cost, if any additional fees. When choosing between various healthcare plans, evaluate which offers the best extra benefits for you.

These benefits may include wellness programs, gym membership discounts, tele-health sessions, and other such benefits. These additional perks could be just the push you need to choose one healthcare plan over another.

There are a multitude of factors to consider when choosing a healthcare plan, and so much involved in the process. These factors listed above are really just the tip of the iceberg. The key is to consider as many factors as possible before making a decision, especially evaluating those key areas that affect you and your family most.

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