How To Get the Best Health Insurance
October 24, 2018
If you don’t have employer-provided health insurance, you’ll need to find a policy on your own. That can seem like a daunting task. But with the right information and preparation, plus a small crystal ball, you can evaluate your options and make an informed choice.
There are some basic options to consider that apply to any health insurance policy. But they can take on different priorities, depending upon whether you’re covering just yourself or your family. Each member of the family is likely to have different needs that should be addressed in the type of coverage being considered, and they are likely to be seeing different doctors.
Cost vs. Coverage
In general, higher premiums may get you more extensive coverage and/or lower deductibles. To help get a feel for the right balance, take a look at the last few years and see whether your current deductible seems appropriate. However, your total “cost” of medical care is the insurance premium, co-pays, deductibles and any out-of-pocket expenses. Your overall financial situation bears consideration as well. You may decide that it’s worth the risk of viewing insurance primarily as protection in the event of a catastrophic injury or illness, with routine deductibles and co-pays handled as they arise.
Provider Network
Depending on how attached you are to your current physician, this can be a major factor to consider. This also applies to specialists you may see periodically. If you want to maintain these relationships, make sure to check the provider databases of potential insurance carriers and make sure they are up to date. If this is not critical to you, then you may have more options available to you. Also, be aware of differences in costs between providers in the carrier’s “network” compared to out-of-network costs. A difficult decision can arise when a physician for the adults in the family is “in-network,” but a child’s pediatrician is not.
Pre-Existing Conditions
For the most part, the Affordable Care Act stipulates that health insurance companies cannot refuse to cover you, or charge you more, based on a pre-existing condition. That’s defined as a health problem you had before new health coverage started.
Age and Health Considerations
Another important factor is the age and health status of you and your family members. Think carefully about what level of care and benefits you need now and in the near future. That said, you can often modify your coverage during annual open enrollment periods as your needs change.
Benefits Included
Efforts have been made to further standardize how health insurance plans are structured, in order to make them easier to compare. Pay attention to the details, especially in the areas of coverage that are most important to you. For example, if you don’t go to the doctor very often, having a co-pay per visit may not be an issue. How about the number and type of prescriptions you require? Do you anticipate having any, or anymore, children? Have you considered dental or vision coverage?
Direct Purchase or Marketplace
The two most basic ways to find health insurance on your own, are directly from an insurance company, often with the assistance of a broker, or through one of the marketplaces (also referred to as exchanges), established as part of the Affordable Care Act. An important potential advantage of the marketplaces are the subsidies and other savings that help offset some of the costs, that is, if you qualify based upon your income level. A potential disadvantage of the marketplaces is that they might come with a smaller network of doctors and specialists.
Health Savings Accounts
If you’re not covered under an employer-based program and are buying insurance as a private entity,, you might want to consider utilizing a health savings account. You can set aside a certain amount of money, tax-free, to draw against medical expenses. The amount of money you’ll save depends on how much you actually use and on your tax bracket.
As you can see, there are many options to consider regarding how to find the best health insurance. KeenanDirect can help you navigate your options and find the choice that’s right for you as an individual or as a family, from expert guidance to enrollment assistance.