A Manual on How to Choose the Right Health Insurance Plan

September 27, 2023

While rising healthcare costs tend to be the primary reason for anyone to consider health insurance, it is not the only one. 

Today, medical emergencies are not uncommon, and aging is no longer the only deteriorative force at play. That is why possible financial implications require immediate actions, like identifying personal healthcare needs and looking into medical plans.

Defining your healthcare needs is essential to understanding how to buy health insurance and choosing an affordable and suitable plan. Depending on your occupation, age, lifestyle, size of your family, and health condition, you can have different expectations from the healthcare plans. 

To pick health insurance that matches all of your requirements and needs, you should be able to distinguish between plans and understand the factors influencing their costs.

The Basics of Shopping for Health Insurance

Today, almost any health condition can be treated if you can afford it. That is why choosing the right policy is crucial to support yourself and your spouse or children. However, any insurance policy requires careful consideration on your part.

Since every medical coverage has different features and requirements, potential policyholders need to understand which offers and policy conditions make sense.

Depending on the insurance provider, you can expect bundle offers, various benefits, and even discount offers. While most working people rely on their employers to provide insurance, you should ensure you are covered if you retire, get laid off, or decide to change a job. Here are the options you should consider if you are planning to purchase health insurance:

  1. The group health plan is your employer’s plan for all the company employees. In case you leave the job, you can get temporary coverage by extending the insurance package you previously had under group insurance. This temporary option is called COBRA insurance.
  2. An individual health plan can cover only one person or the whole family, depending on your requirements and needs. Any individual plan can be bought directly from the insurance company of your choice or the marketplace. Since individual plans come in various forms and sizes, you need to figure out which fits your needs best.
  3. Medicaid is a federal and state program that offers coverage to people with low income and limited resources.
  4. Traditional Medicare offers plans to people over 65. In a nutshell, it provides a range of options, like Part A for formally admitted patients, Part B for patients with no hospital admission required, and Medigap as a supplemental policy.
  5. Medicare Advantage provides multiple plans with specific restrictions, costs, and benefits. The most common plans are HMO, PPO, EPO, POS, and indemnity plans. In this case, it is crucial to consider how much freedom you require and whether you want to manage your healthcare. Every plan has different enrollment conditions and networks of doctors and hospitals, establishing specific limits.
  6. Catastrophic plans are created for clients facing severe financial hardships. These plans are designed primarily for people under 30.
  7. Supplemental insurance is designed to cover the costs and conditions typically not covered by other insurance plans, like vision, disability, or dental insurance.

While comprehensive plans can come in handy and protect you from paying substantial medical bills, routine services and checkups can often be omitted. However, there are other advantages and benefits to choosing them. 

For instance, such extra offers as reimbursement for flu shots or gym memberships. As for the latter, it is common for insurance companies to encourage policyholders to stay fit and attend the gym regularly. While Traditional Medicare does not offer such benefits, some options are available through Medicare Advantage and Supplemental insurance.

Choosing an Appropriate Insurance Plan

Picking the right insurance policy requires getting essential information on the most common plans and understanding your needs. To make sure that you are on the right track, you need to review all the available options, shop around, and ask yourself important questions (study the types of medical insurance available in the US).

One of the main tasks is to figure out how often you see a doctor on average. It is also crucial to consider if you take any prescription drugs or have unhealthy habits like smoking.

Besides, you need to understand that if you want to see a particular doctor or use the services of a specific hospital, the variety of available insurance options will drastically decrease. That is a short list of what you need to consider before buying a policy.

Apart from identifying and clearly stating your needs, it is necessary to balance your choice’s costs and coverage. That is when your Math skills will come in handy. Depending on a policy, you will face different levels of premiums, copayments, deductibles, and even co-insurance. 

That is why most of the policyholders make their decisions based on the predictive capacity and affordability of the available options. After all, finding the right balance is the key to getting suitable coverage and feeling good about it.

Victoria Berezhetska

Victoria Berezhetska is a Content Lead at Phonexa.com and an expert contributor to CoverExplore. She has a Bachelor of Science degree in Business Administration, with extensive working experience as a PR specialist and content writer. At CoverExplore, she helps customers find the right educational material through easily digestible blog posts and buying guides backing their insurance coverage choice. Victoria covers diverse topics around digital and insurance marketing, including auto, home, health, and life insurance.

We will be happy to hear your thoughts

Leave a reply