Just as consumers diligently scan websites to score a bargain on big-screen TVs, why not challenge yourself to get the best value when shopping for health insurance?
You’re probably thinking – because it’s confusing and overwhelming. It’s true health insurance can seem complex, that’s why giving yourself more time to consider the options will make the process smoother.
Open enrollment through the Health Insurance Marketplace (healthcare.gov) started on Nov. 1, so it’s time to start shopping. Health insurance companies have also publicized their plans and provided tools to help customers “window shop” and compare options. This gives you the opportunity to investigate, gather knowledge and resources and ask questions to ultimately make an informed decision about your health insurance purchase.
It’s time to campout on your computer (which is much cozier than camping outside of Best Buy) and start shopping for the best health care options.
Here are seven tips to help you successfully shop for your health care plan:
1. Don’t leave it to the last minute. Open enrollment began on Nov. 1 and lasts through Jan. 31, 2016. However, if you want your coverage to begin on Jan. 1, you MUST enroll before Dec. 15, 2015.
2. Understand the common types of health insurance plans and know how they compare. Health care plans on the Marketplace are sold by metal level – bronze, silver, gold and platinum. Metal levels are determined by the level of benefits the plan offers. Generally, bronze plans have the highest out-of-pocket costs, but offer the lowest premium, whereas a platinum plan pays for more of the out-of-pocket costs, but have a higher priced premium.
3. Take the time to research and get acquainted with the common acronyms used to identify specific plan types, such as:
- HMO or health maintenance organization: A plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. HMOs often provide integrated care and focus on prevention and wellness.
- PPO or preferred provider organization: A plan where you are covered if you stay in-network or out-of-network. However, you pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
- POS or point-of-service plan: A plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You are covered if you go out-of-network, but you will pay more for services. Care is also coordinated through a primary doctor.
- HDHPs or High-deductible health plans: A plan which is be linked a health savings account (HSA). The funds contributed to the HSA account aren’t subject to federal income tax and must be used to pay for qualified medical expenses. Unlike a Flexible Spending Account (FSA), funds roll over year to year if you don’t spend them.
4. Talk with your primary care physician about the plan that best fits the needs of your family based on previous and current medical conditions. Discuss the services you use and how often you use them. For example: if you have a chronic condition that requires you to regularly take prescription medication and visit the doctor for diagnostic tests at least once a year, you may need a plan that has lower out-of-pocket expenses.
5. Be clear on everything that your plan covers and look at the total financial cost, as opposed to the monthly premium. Evaluate the plan’s deductible, co-payment and the maximum amount you could be responsible for paying out-of-pocket each year.
6. Know your provider network. Health plans offer a variety of options to consumers, including more limited provider networks. For instance, a narrow network plan is affiliated with specific hospitals, physicians and doctors that fall under one health system. This may work for you, it may not. You need to make sure that the providers that you want to see are included within your plan network.
7. Reach out to a health insurance agent to discuss your options. Agents should provide unbiased information about all of the plans available to you and can help you leverage the information you’ve gleaned from tips 1 through 6 to ensure you choose the best option.
Explore your choices now. Being informed and researching individual plans can mean more options, better coverage and ultimately, more money saved.