Having insurance coverage, either an individually-acquired one or one paid through your employer is imperative for your overall health security. However, even more important is getting the right health insurance plan to ensure that you are well covered and able to pay for it.
There are many health insurance vendors in the market, and all are competing to get you under their umbrella. Many of them have been known to be really good at hiding what’s in their plans, but the Affordable Care Act has set to change that. So, why is it so important to purchase the right insurance plan? And if you already have one, how can you tell if it’s the right one? Here are a few reasons:
1. Wide Coverage Options
The first benefit to having the right health insurance plan is that it gives you an extensive coverage and pays a huge chunk of your expenses when you need it. Generally, a great health insurance coverage should include all essential benefits which include doctor visits, hospitalizations, outpatient treatments, tests, medications, preventative care practices like mammograms and immunizations, pediatric care, rehabilitation, substance abuse and mental health care, and such. It’s important to know exactly what your plan covers so that you don’t get the shock of your life upon realizing something you are suffering from is excluded from the policy.
2. Affordable Monthly Premiums
A good health insurance plan is one which you can affordably pay the set premiums without putting much strain on yourself. Depending on your budget, you should choose the highest available maximum that you can afford. Companies often categorize health insurance plans affordability as bronze, silver, gold, and platinum. These plans only show how you and your provider share costs, but they have nothing to do with the quality of care.
3. Little Out-Of-Pocket Expenses
Having the right insurance coverage will ensure that your out-of-pocket expenses are not a burden to you. You should look at the amount of your deductible each year and determine if it’s affordable. The deductible is the amount that you have to pay out of your pockets before the insurance can start paying for the rest of the expenses.
Some insurance plans will need you to pay the deductible amount before they can cover office visits while others will require you to make co-payments for office visits, and this will not count towards the deductibles. It's important to take a look at your copay and coinsurance (amount you are accountable for after the insurance pays its part) costs. Those with high sharing ratios like 80/20 or 90/10 are best.
4. Network Coverage
Even the most comprehensive insurance plan in the nation is not the best if it can’t help you find a healthcare professional that accepts it. The best plan is one which allows you a broad network of healthcare professionals to choose from. Most plans provide online tools to help you search for hospitals and physicians to see if they are in the defined network. You can also contact the hospital or doctor directly to find out if they accept the insurance plans you are considering.
If you want a wide range of options and flexibility, consider a PPO (preferred provider organization). They may have a defined network, but can at least allow you to seek help outside the network if you want.
5. Business Benefits
According to the Affordable Care Act, employers with over 50 employees are required to cover at least 60% of their employees’ medical expenses.1 However, it's important to understand all your available options as there may be better plans offering even more than that. If you are able to get your employees these plans, you can give them more coverage and their gratitude is more than likely to double or triple. And as a result, they will be more comfortable, happy and productive at work.
Don’t just buy any health insurance plan out there. Do some due diligence to find the one with the most benefits and is perfect for your case!
This content is developed from sources believed to be providing accurate information. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security.