The ABC's to Choosing Your Plan

Now that you know the plan types and the terminology, it’s time to shop! Finding the right health plan that has all your needs and is within your price range can be stressful. Here are some helpful hints you may want to think about as you are searching:

  • Know your price range: The first thing you need to know is how much you can afford to spend on your health plan. Once you have established a price range, take a look at some plans that fall in between your range. Not only will you be able to compare total premiums for these plans, you will also be able to compare covered services within these plans.
  • What type of coverage do you need?: Try and figure out what covered services you want in your plan. If you know you will be having an upcoming surgery you may want to have a plan that has a flat copayment for out-patient surgery versus having to satisfy a high deductible.
  • Think Logically: Try to find a balance between premium and covered service. Find a plan that gives you the coverage you need at the price you want.
  • Ask Questions: Don’t be afraid to call the insurance carriers if you have questions about a specific plan. They are there to make the shopping process easier.

The ABC’s to Knowing the Right Price to Pay

The key to choosing the right health insurance plan is to find a plan that’s within your budget and provides you with the coverage you need. Having a plan that does not cover all the services you may need may be costly financially.

Price & Coverage: The price of an insurance plan is one of the first things you are going to look at to see if a specific plan is right for you and your family. However, the price is not just about monthly and annual premiums. It also includes out of pocket costs such as copayments, deductibles, & out-of-pocket maximums. Make sure to include these costs in your budget.

  • Having enough coverage is next important item you want to consider. Make sure you choose a plan that has all the services you may need. Some people may want a flat copayment plan with no deductible, but what people have to remember is the out of pocket maximum may be higher compared to a deductible plan. This means you may be at risk for more out of pocket costs. The good thing about deductible plans is they usually have lower premiums than copayment plans and their out of pocket maximums are reasonable. The amount of coverage a plan has and the price are directly related. You may believe copayment plans are better than deductible plans because you don’t have to pay more upfront. What people don’t realize that if you have an accident a patient will be subject to numerous copayments which a non-deductible plan will have to pay each visit.
  • For example, (Plan A has no deductible and a $1,000 copayment for any in patient services. The out of pocket maximum is $5,000. Plan B is a $500 deductible plan with an out of pocket maximum of $1,500). If a patient has Plan A, he or she will have to pay $1,000 for each in patient service and any coinsurance or copayment will contribute toward the $5,000 out of pocket maximum. If the patient has Plan B, he or she will only have to pay $500 for the in patient service once. Once the patient reaches his or her deductible, the insurance company will cover all costs in full. Again any coinsurance or copayments will contribute toward the $1,500 out of pocket maximum.
  • A patient with Plan A will be subjected to more out-of-pocket costs compared to a patient with Plan B. Please make sure you know what your plans out of pocket maximum is because it will help you determine what the maximum amount you will be paying for health procedures on top of your annual premium

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