As the medical expenses are soaring, the health insurance becomes even more significant in our lives. When you have employer health insurance plan, you don’t have much say on the type and coverage of the plan. Mostly the employers provide one or two options to choose from and in most of cases. It is the uniformed plan for the employees with only the coverage or sum assured variations as per the responsibilities or the position held in the company. However, when it comes to the individual health insurance plans, there you have plenty of options to choose from. But the negative side of it is that the market is flooded with the individual health insurance plans in good enough capacity to confuse you to the core to decide which policy will be the best for you. Here are 8 keys to choose individual health insurance plan.
1. Your Must-haves
You can not anticipate the medical expenses as you cannot foresee the injuries or medical emergencies. However, maternity is something that you can plan and not all policies provide the maternity coverage. Therefore, Maternity coverage is a must-have for you, if you are planning to start a family.
2. The cost of the basics
There is no point thinking about a health insurance plan with very high premium that you cannot afford. Be more practical while deciding on the individual health plan. If you are young and healthy, then you must choose a plan with high deductible, where the total you will have to pay, generally over $1000, before the benefit kicks in. Make sure that you have taken into your account the basic expenses of co-pay like office visit or tests and also you have kept the co-insurance in mind that is your share to be paid in case of hospitalization or any other medical emergencies.
3. Provider networks
In most cases people have their primary care physician or favorite specialists whom they prefer to visit. If this is the case then make sure that the specialist or physicians also participate in the health insurance plan’s network. Generally for out-of-the network coverage the insurance company will cover a lower cost, or will not cover it at all.
4. Out-of-pocket maximums
There are plans where there are no limits on the amount you need to pay over the years, no matter how high the expense is. Similarly, there are plans where you have to make the co-payment. Choose a plan without an annual cap. Normally in such cases without limits also the expenses will be covered only when the insurance company will find them medically necessary.
Make sure that any prescribed drug that you are taking regularly is covered in the plan. Read the fine lines in the plan’s list of medications, it will show you whether the prescribed drug is covered or not. The list of medication changes as per the company and the plan. Be careful while deciding on the plan. You surely would not want to repent at the time of medical emergency.
6. Annual limits on coverage and services
The annual limit on coverage and services is a tricky part and you must be aware of the limits while deciding on the plan. Thanks to the latest health reforms in the United States, the annual dollar limit on the health coverage will disappear. For now, if you are a U.S citizen, you cannot have a lower than $750,000 for an individual policy. Above that amount, you will have to pay full cost of care, once the policy has been exhausted. There can also be separate caps for different services like prescription, surgery or rehabilitation services. Make sure you go through the detailed information about the caps on the services as well.
Dependent children can also be a part of your policy, if they are below 26-years of age and are not covered by their employer. The children under-19 with pre-existing conditions can also not be excluded now from being a part of your policy.
8. Getting help
ealthcare.gov H, launched last summer. The basic information about buying a health insurance is also available on this site. If you want to speak to a live person to take you through the details of the policy, National Association of Health Underwriters will help the consumers in the US with the names and contacts of the local agents and brokers.You can get the in-depth details about the insurance policy without revealing your details like name, contact number, address etc. For the United States, the federal government has provided the consumers with a tool to compare the policies and finding the details through Healthcare.gov, launched last summer. The basic information about buying a health insurance is also available on this site. If you want to speak to a live person to take you through the details of the policy, National Association of Health Underwriters will help the consumers in the US with the names and contacts of the local agents and brokers.