When deciding on health insurance, one needs to be aware of his or
her needs first and foremost. Many plans are similar but slight
variations in coverage and expense. Most insurance companies offer
similar deductibles and cover all the standard routine issues that
arise in health. Some plans are more expensive and make the insured
responsible for more expense but offer a wider range of control.
Some plans are designed for the budget consciences individual and
has more restrictions but costs less. So look at what type of
health needs you have and think about how often you need to visit a
doctor. Make sure your doctor is cooperative in giving referrals
when needed as well. Here are some things to think about when
deciding what plan is best for you.
1) What plan benefits are offered to the insured? Most plans
provide normal medical coverage. But see what other services you
may need and if they are available easily or at all. Make sure that
you are aware of any additional fees that might be placed on you if
you see certain types of doctors or other medical professionals.
Does this plan have restrictions on pre-existing conditions or
chronic illnesses that can cause a premium increase or higher
co-pay in the future. Know what you are getting and make sure that
it works for you. If you aren’t sure call the company directly and
speak to someone who can answer all your questions.
2) Physical exams and health screenings as a form of entry into a
plan. Does this work for you or not, and do you not want to
disclose your medical issues prior to getting a quote. Many
insurance companies want to have you seen by one of their
physicians to make sure you won’t cost them money by having any
chronic illnesses. If you have some medical conditions that require
frequent visits and treatments you may not want to look at these
providers for help with coverage.
3) Care by specialists. If you require the care of specialists,
such as a cardiologist, nutritionist for diabetes or obesity, or
any other type, you want to make sure this is fully covered on your
chosen plan. You don’t want to just sign up for a plan that is in
your price range and then find out you can’t see the doctors you
need to. Be sure to see all the information on added coverage above
and beyond just basic needs.
4) Hospitalization and emergency care. Most HMOs require a referral
from your primary care doctor before you may go to the hospital.
Some insurance companies will not pay for hospital visits on the
weekends unless the doctor was called and gave the referral prior
to you going. Some will even require that you wait till the next
available business day to see your doctor first if it isn’t a life
or death emergency. If you have conditions that might require a
trip to the hospital, be sure that your policy works for you. In
the middle of a panic attack is not a good time to wait for the
“on-call” to call you back, give permission, and call the hospital
for you. You need to know that are safe to call and get emergency
care and get the referral the next business day.
5) Prescription drugs and what will the company pay for? You might
want to take into account how many prescriptions you need and what
the cost of each one is. If you are used to small co-pay, it can be
a slap in the face to find out you have to pay 20% of a $150
prescription. Many people who require some or lots of daily
medications will benefit more from a HMO that has a small fee like
$5 or $10 per prescription and/or a small deductible.
6) Vision care and dental services. Find out if these are included
in your plan or whether you need to purchase one or both
separately. Many plans will include yearly and emergency eye exams
and visits. Also many offer some coverage on eyewear to some
extent. Most dental plans are separate and require a separate
insurance or slightly higher monthly fee to be added.
DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any