USHealth Group Identifies 3 Key Factors in Insurance Shopping
People who dread the annual ritual of selecting a health insurance plan can take solace in the fact that they are not alone in being overwhelmed by the difficulties of health plan choice. For many individuals, choosing a health insurance plan is a source of significant distress and confusion. The complexity of health plan choice is the result of a sheer number of options and the wide variations among them.
The health insurance plan options can range in the hundreds per state. Consumers looking to make informed choices across plans have to evaluate the trade-offs between the features they offer. Herein is a brief overview of some of the key aspects USHealth Group considers important when choosing an insurance plan.
1. Health Plan Revision
Insurance firms contract lower fees when it comes to in-network healthcare providers. As such, insurance costs are significantly lower when healthcare is provided by an in-network doctor. It is advisable to contact doctors with whom relationships have been established and inquire about the plans they accept. It is best if the preferred doctors are in provider directories for the selected plan.
Doctors out of network will exhibit non-contracted rates thus resulting in higher costs for the insurance company and consumer. Consumers who do not have preferred doctors should opt for plans with larger networks. This is especially important in rural areas where it is easier to find a healthcare provider taking the plan. Plans that lack local in-network doctors or have fewer provider options should be eliminated.
2. Cost Analysis (Minimum Definite Costs & Maximum Possible Costs
How costs are shared is a factor that should never be neglected. Consumers should note the minimum annual cost and the maximum possible cost of the health insurance plans they consider. This information should be made readily available by employers and government insurance exchanges. There are also websites that collect exchange plan information.
The sum of monthly premiums over a period of 12 months is the minimum cost. This amount is payable regardless of whether healthcare is received or not for the entire duration of the plan. The maximum possible cost is the sum of maximum out-of-pocket costs and the aforementioned annual premium cost.
The total amount that a consumer spends out of pocket yearly is limited. The maximum will be included in the insurance plan information. Maximum possible costs can be very high especially if the consumer requires significant health care including:
• Having to see a doctor (specialist or primary physician) frequently.
• Needing frequent emergency care.
• Taking expensive medications on regular basis.
• Requiring physical therapy.
• Having an upcoming planned surgery.
• Expecting a baby.
• Being diagnosed with a chronic conditions such as cancer or diabetes.
Premiums can increase if an expectant family adds the baby to the insurance plan. This is in addition to extra costs in the form of prenatal care and delivery. There are also annual deductible requirements for the new addition.
3. Consideration of Expected Healthcare Needs
A plan with lower monthly premiums is the financially smart choice for consumers who are in great health and rarely need to visit a doctor. It is also recommendable to individuals who:
• Are not expecting to have a baby in the duration of the insurance plan.
• Have no worries about being afflicted with unexpected illnesses.
• Do not engage in sports or other activities that can cause injury.
• Do not have a history of chronic conditions in their family.
• Cannot afford high monthly premiums for insurance plans with low out of pocket costs.
Placing more emphasis on the premiums means that the plan will have higher out of pocket costs. Fortunately, consumers who fit the above criteria have less likelihood of owing more than the minimum amount they will have to pay.
On the other hand, there are the consumers that are better off selecting plans with higher monthly premiums and lower out of pocket costs. They include older individuals (40 years and above), people with a family history of disease, those with an injury prone lifestyle, individuals with previous health conditions and expectant families.
The high monthly premiums may seem like a lot but can result in huge savings over the duration of the plan. It is also good practice to compare the deductibles and summary of benefits. Neglecting this can result in consumers missing out on insurance plans that are better tailored to them and their families.
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