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).
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.
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