How Do I Choose The Healthcare Plan That's Right For Me?
The simple answer is, to make the right decision, you need to ask yourself the right questions. Think about the ways you use healthcare, the medical needs you can foresee, and the state of your budget. Your answers will guide you to make the right choice.
Questions to Ask
First, do you want basic insurance coverage or something more comprehensive?
Basic plans are designed to protect your finances in the event of a major illness or serious injury. They don't cover smaller, out-of-pocket expenses like doctor's office visits, and they generally cost less.
Let's say our friend Gary, who is very healthy, had an unfortunate experience while ballooning over the Alps. His basic plan would help save him from financial ruin by covering most of the major medical expenses to get him back on his feet. If you just want to cover the big things, a basic plan may be your best option.
Other healthcare plans offer more comprehensive coverage, including things like immunizations, checkups and maternity care. But monthly premiums are higher. They're a good choice for people who plan to have frequent medical care.
How much can you spend for a healthcare plan?
As you consider your needs, take your budget into account. Factor in how much you can afford to spend on premiums and co-pays and how it impacts your lifetime maximum. Know the plan's deductibles. Balancing cost and coverage is key.
Are you single or married?
If you're single, one-person coverage may be all you need. But, if you're married, like Gary, or plan to be married soon, make sure your plan covers your spouse. And if you have children, you'll want the family plan. Picking the right insurance is a lot like buying a car. Is a two-seater all you need, or will a van be a better choice on the road of life?
Are you planning to have children or is your family about to grow?
Then you need maternity coverage. Gary, our dad-to-be, needs to make sure that prenatal care, labor and delivery are included in his plan.
Does anyone who will be covered need prescription medication frequently?
If so, a prescription drug benefit could be important.
Is your doctor part of the healthcare plan?
Most managed care plans like PPOs and HMOs cover a network of providers and facilities. To get the highest level of benefits by using doctors and hospitals that are part of their network, you can save a lot of money. So be like Gary and check the plan's provider directory to see if your physician is in it.
Do you want easy access to healthcare specialists?
For example, if Gary is having back trouble, he may want to go straight to the specialist his Uncle George swears by. Some plans would require him to get a referral from his primary care physician.
Do you have other specific healthcare needs?
Maybe you're on the road a lot. If so, you might want a plan that will cover you whether you're in New York or New Guinea. Or maybe you need coverage for mental health or nursing care. Now's the time to think about it.
Summary – Choosing the Right Healthcare Plan
There are a lot of options that allow you to custom-tailor a health plan. To choose the one that's right for you, ask yourself the questions that will help you assess your needs. Figure out how much you can spend on premiums and co-pays. And study the plans to understand what you're getting for your money.