7 Crucial Things to Consider When Buying Health Insurance
Shopping for health insurance as an individual, family, or small business now may seem daunting at first, but it doesn’t have to be complicated. there are certain things you want to look for, of course. price is always a factor, and that can often be difficult to measure.
It all comes down to how much you want to pay. How much can you afford to pay each month? Like car insurance, the more money you pay each month, the more financial coverage you have in case of unexpected expenses.
Too often, consumers will only look at the monthly premium when determining the right health insurance for them. Monthly cost should definitely be a factor, but focusing on price alone can cause problems and end up costing you more in the long run. So what else should you consider when shopping for health insurance?
That said, here’s some basic but essential information you’ll want to consider when shopping for health insurance:
premium
This is the total cost of the health insurance plan that you, as a consumer, will pay monthly or in full. how much you pay depends on what benefits are included in the plan. Please note: This amount is separate from the deductible.
To keep your cost down, there are a few factors you can control to save money: your deductible, copay, and coinsurance amounts.
the infamous deductible
The deductible is a fixed dollar amount that the policyholder must pay before insurance will pay for most services. This is the total amount that you, as a consumer, must first pay for any medical expenses you receive during your coverage period. covered medical expenses after this amount will be paid by the health insurance company according to the policy (for example, you may still be subject to copays and coinsurance).
For example: If your deductible is $1,000 and you have a hospital bill of $3,000, you would pay $1,000 and the health insurance company would pay most of the remaining $2,000 (you may be subject to coinsurance up to the out-of-pocket maximum). of the policy amount). Generally speaking, the higher the deductible, the lower the premium.
Higher deductible plans are especially beneficial for those who rarely visit the doctor or buy prescription drugs. if you’re not going to use it, why pay more for it? Even with a high deductible plan, you’ll still be covered in the event of an emergency. although you will still have to pay the deductible amount, it is still less than the cost of most emergency procedures. High deductible plans are a great option for those in good health.
on the other hand, people who have a lot of medical expenses (such as surgeries) would save more money by opting for a plan with a lower deductible.
copayment
This is the cost the consumer pays in addition to the premium each time they see a doctor or health specialist. copays also apply to emergency room visits, urgent care visits, and prescription drug purchases.
Please note: The copay(s) do not apply to your deductible and will remain your financial responsibility even after you meet your deductible.
Your copay costs will depend on how much you pay monthly for your health insurance policy. In general, the higher the premium, the lower the copay. conversely, lower premiums typically have higher copays. therefore, if you take prescription medications or need frequent medical appointments, you may want to invest in a lower copay plan.
coinsurance
This is the percentage of a medical bill that you must pay after the insurance company pays its share. The amount the health insurance company pays will vary based on your benefits and is only done once you have met your deductible.
Please note: Coinsurance is paid in addition to copay.
The money you pay with each office visit is applied to your deductible. once you’ve paid the full amount (meaning you meet your deductible), you’ll still be responsible for coinsurance.
For example: If you have a $1,000 medical bill and a $5,000 deductible, how much you actually owe will depend on three questions:
- Have you met your deductible?
- what is your coinsurance percentage?
- What is your maximum out-of-pocket cost?
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If you haven’t met your deductible, you’ll owe $1,000 (to be applied to your deductible). If you have met your deductible, you will owe a percentage of the bill (your coinsurance). so if your coinsurance is 20%, you would pay $200 and the insurance company would pay the remaining $800.
Once you reach the out-of-pocket maximum (for example, $5,100), the health insurance company will cover the rest of your medical bills for the life of the policy. however, it is always wise to know exactly what services and conditions are covered by your health insurance plan, as it can vary greatly from policy to policy.
Which of these factors are most important to you in a health care policy?
provider network
we’ve all been there. you or your child get sick and go to your preferred doctor only to find out that your insurance policy is not accepted there. At that point, you must either pay out of pocket and hope your policy has a good out-of-network benefit, or find a new unknown doctor. the provider network is always available and updated online.
Check to see if your providers and hospitals are covered. Some short-term health insurance plans are non-network, which means the insurance will pay a service-based fee at almost all providers. in that case, it’s best to check with your insurance to see what it will cover and confirm with your provider that its price is in line with what the insurance will pay.
pharmaceutical coverage
If you take medications, check to see if your medications are covered, if you’ll need to buy the generic, and what the copay for your medications will be. if you haven’t investigated this, there could be a problem. A drug covered by your old insurance plan that cost just a few dollars could now easily cost more than $100.
dental
Most dental procedures are not covered by health insurance. These procedures can be expensive, but dental insurance premiums can be very low. It’s a good idea to purchase dental insurance when you purchase your health insurance. get a quote now.
Which insurance is best for you?
Not all insurance is created equal, and what may work for you may not work for your neighbor. Evaluate your medical needs and health situation before purchasing insurance. Some people may need a platinum level obamacare plan because they are constantly in and out of the doctor’s office or hospital, while some people may simply want the peace of mind that a limited benefit medical indemnity insurance plan offers, which includes limited benefits. as a fixed – indemnity payment if you need medical services due to an accident or illness, and can be combined with lifestyle benefits such as prescription drug discounts and telemedicine. spending a little time determining your needs can save you thousands of dollars.
choose wisely
There’s no one plan that’s right for everyone, which is why there are so many health insurance options on the market. If you have a history of being healthy and are comfortable foregoing some of Obamacare’s 10 essential benefits (maternity, mental health), then a short-term medical plan may be a good health insurance option. If you prefer a stronger plan with all 10 benefits, then an Obamacare plan is a better option. It is recommended that you compare health insurance plan benefits to find the one that best suits your needs.
Obamacare to 2019: Major Changes in Health Care Reform
Health insurance is changing, once again.
In 2010, when the Affordable Care Act (also known as Obamacare) was passed and implemented, health insurance became mandatory for all Americans. residents this sparked a debate from washington to colorado, from texas to florida and everywhere in between. Should health insurance be required? should everyone pay the same? should it be free?
many healthy people applied for health insurance for the first time, because they didn’t want to be subject to a hefty tax penalty of $695 (or 2.5 percent of their household income, whichever was greater).
As of 2019, however, the tax penalty disappears.
short-term health insurance = smart move for transitions
Short-term medical insurance (also known as short-term medical insurance or STM) is a temporary option for people going through life-changing events such as divorce, graduation or job loss, starting a business, join the informal economy, etc. stm is exempt from the affordable care act. requires subscription and does not have to meet the minimum essential health insurance requirements. Therefore, those with STM plans were subject to a tax penalty. Since this will no longer apply from 2019, now is a great time to shop for a new stm plan, which offers flexible accident and sickness benefits at an affordable price.
If any of these terms are unfamiliar, check out our glossary for definitions.
Do you have health insurance?
if not, you need it. it’s like driving a car; you want to make sure you are covered in case of an emergency. you never know when you’ll need it, but you’ll thank yourself later.
Have you looked for a short-term medical plan?
can you afford not to?
