Things to Look for in a Health Insurance Plan

When deciding on health insurance, one needs to be aware of his or her needs first and foremost. Many plans are similar but slight variations in coverage and expense. Most insurance companies offer similar deductibles and cover all the standard routine issues that arise in health. Some plans are more expensive and make the insured responsible for more expense but offer a wider range of control. Some plans are designed for the budget consciences individual and has more restrictions but costs less. So look at what type of health needs you have and think about how often you need to visit a doctor. Make sure your doctor is cooperative in giving referrals when needed as well. Here are some things to think about when deciding what plan is best for you.

1) What plan benefits are offered to the insured? Most plans provide normal medical coverage. But see what other services you may need and if they are available easily or at all. Make sure that you are aware of any additional fees that might be placed on you if you see certain types of doctors or other medical professionals. Does this plan have restrictions on pre-existing conditions or chronic illnesses that can cause a premium increase or higher co-pay in the future. Know what you are getting and make sure that it works for you. If you aren’t sure call the company directly and speak to someone who can answer all your questions.

2) Physical exams and health screenings as a form of entry into a plan. Does this work for you or not, and do you not want to disclose your medical issues prior to getting a quote. Many insurance companies want to have you seen by one of their physicians to make sure you won’t cost them money by having any chronic illnesses. If you have some medical conditions that require frequent visits and treatments you may not want to look at these providers for help with coverage.

3) Care by specialists. If you require the care of specialists, such as a cardiologist, nutritionist for diabetes or obesity, or any other type, you want to make sure this is fully covered on your chosen plan. You don’t want to just sign up for a plan that is in your price range and then find out you can’t see the doctors you need to. Be sure to see all the information on added coverage above and beyond just basic needs.

4) Hospitalization and emergency care. Most HMOs require a referral from your primary care doctor before you may go to the hospital. Some insurance companies will not pay for hospital visits on the weekends unless the doctor was called and gave the referral prior to you going. Some will even require that you wait till the next available business day to see your doctor first if it isn’t a life or death emergency. If you have conditions that might require a trip to the hospital, be sure that your policy works for you. In the middle of a panic attack is not a good time to wait for the “on-call” to call you back, give permission, and call the hospital for you. You need to know that are safe to call and get emergency care and get the referral the next business day.

5) Prescription drugs and what will the company pay for? You might want to take into account how many prescriptions you need and what the cost of each one is. If you are used to small co-pay, it can be a slap in the face to find out you have to pay 20% of a $150 prescription. Many people who require some or lots of daily medications will benefit more from a HMO that has a small fee like $5 or $10 per prescription and/or a small deductible.

6) Vision care and dental services. Find out if these are included in your plan or whether you need to purchase one or both separately. Many plans will include yearly and emergency eye exams and visits. Also many offer some coverage on eyewear to some extent. Most dental plans are separate and require a separate insurance or slightly higher monthly fee to be added.