Choosing The Right Health Insurance Plan

May 7th 2016

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Choosing a health insurance plan is one of the most important financial decisions you will make. You want to ensure that you and your family are adequately covered for any medical issues that may arise.  Finding the right healthcare insurance plan involves purchasing one that will meet your needs and fit your budget. Due to the different ways health insurance plans were marketed in the past, it was difficult to differentiate between their advantages and disadvantages.

The 2013 Affordable Care Act (ACA) has established a standardized healthcare insurance marketplace that makes it much easier to make a side-by-side comparison between plans now. This should significantly reduce the amount of time you need to spend researching and selecting the right health insurance plan.

Overview of the Healthcare Insurance Marketplace

As part of the ACA, the Health Insurance Marketplace was established. The marketplace makes it easier for individuals and small businesses to compare different healthcare plans. All of the plans that are featured in the Health Insurance Marketplace now cover core healthcare needs, including checkups, maternity care, emergency care and prescription drugs. Most marketplace healthcare plans also include free preventive care, like screening shots. The ACA also means that people with pre-existing conditions can no longer be discriminated against. They now have access to the same plans and at the same price as anyone else. 

Tips for Choosing the Right Healthcare Insurance Plan

While the Health Insurance Marketplace has made it easier to compare plans, there are still important factors you need to think about before making your choice. Here are seven tips for selecting the right health insurance plan.

1. Look beyond Just the Monthly Premiums

Monthly premiums on your health insurance are important, but they are not the only factor to consider. If your plan comes with lower monthly premiums, then the out-of-pocket costs will usually be higher if you need care. Conversely, higher premiums will typically mean lower out-of-pocket costs.

2. Consider any Major Upcoming Life Changes

Think about any significant upcoming life changes that may affect the amount you spend on medical expenses. For example, if you are planning on having a child in the next year, then you may want to select health insurance that will cover more maternity costs, even if this means paying a larger monthly premium.

3. Think about the Frequency of Visits to the Doctor

Do you expect to visit your doctor frequently, or will you usually only visit them once a year? Determine in advance how often you will likely visit your doctor. If you to visit your doctor infrequently, then you can choose a health insurance plan with lower monthly premiums that charges you more for visits.

4. Keep Your Existing Doctor or Find a New One

If you want to keep your existing doctor, then you may be more limited in your choice of plans. On the other hand, if you have a doctor that you really want to keep, then make sure that they are part of your insurer's network. In this case, health insurance plans that your doctor does not work with can be eliminated.

5. Cover Your Dependents

If you have children under the age of 26 who do not have health insurance from their employer, you can put them under your own health insurance plan. Children with pre-existing conditions under the age of 19 can no longer be excluded from coverage.

6. Think about Online Self-Service Options

If you don't want to talk to health insurance representatives on the telephone or if you prefer the convenience of Internet access, you should check to see what kind of online service options are provided. These days, many health insurers provide mobile applications or online self-service options.

7. Look at the Insurer's Prescription Drug List

If you have a  medical condition that requires you to take prescription drugs, you  should make sure that it is included in their covered list. If the  prescription drug is not in the covered list -- also known as their  formulary -- then you will want to select a different plan.

The Health Insurance Marketplace has made selecting a plan a more streamlined and open process. If you are not happy with the plan that you select, you can change the plan when enrollment opens again next year. The most important point is to select a plan and ensure that you and your family are covered. The worst decision is not having any health insurance at all.


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