Does the health insurance policy meet the minimum standards?
Do you know what is covered?
How good is their network of providers?
How well is it priced?
Are you getting the best deductible?
You should know that your healthcare insurance company is really a medical insurance carrier and meets the minimum standards for your state.
Some companies selling what appears to be medical insurance are selling discount plans. These plans can lower your medical expenses in some scenarios, but do not provide substantial coverage. They will often use names that are sound very similar to the names of well known healthcare insurance companies.
The best way to make sure that you are dealing with an actual healthcare insurance company is to check with your state’s department of insurance. They will have a list of approved medical insurance carriers.
You should know what a given health insurance carrier covers and does not cover.
You should read the outline of coverage or brochure for any medical insurance contract you are considering. There will be a section that mentions the “exclusions and limitations.” Read this section carefully. Most of the items in this section will be the same from policy to policy. However, this won’t be 100 percent correct. Make sure that you are comfortable with the things the plan doesn’t cover.
You should understand how good their network is in your vacinity.
Is your doctor in the company’s network? If not, are there other providers in the network who are near you? Is your local hospital in their network? Will you be able to get emergency coverage when you are on vacation in another state?
If you are a have a second home that you live in for extended periods of time, it is important to know if you can get your routine care in taken care of in the area surrounding that other location. Most contracts will cover emergency care well whether or not you use network providers. However, many will not cover routine care well if at all if the services are performed outside of the network.
You should know if a contract is well priced. Make sure that it is competitively priced when compared to other similar health insurance policies from other healthcare insurance carriers. You may be surprised to know how much of a price variance there is between similar medical insurance contracts.
You should know if a plan is priced well when the deductible and other cost shares are concerned.
This involves doing a little arithmetic. When comparing two similar contracts with different deductibles, be sure to annualize the deductible and the premiums when comparing policies. Often when we do this we are able to pick out bargains. Although it is true that when you pay more for a policy you can expect to have a lower deductible and vice versa, you may find that the premium drops faster than the deductible rises.
Look at your net costs in different scenarios. This will help you determine whether a carrier is charging too much for a low deductible contract. Calculate your total costs for your health care expenses when you include not just your annualized premium and your annualized deductible and other cost shares. You will probably find that a medium or even a high deductible plan will be your best option.
The more knowledge you have, the better choices you will make regarding your health care insurance policy. Knowing if a policy meets your state’s minimum standards, knowing the limitations of the contract, making sure that the network is adequate and being able to judge prices and deductibles are all important when it comes to finding the best health care insurance policy for your family.
