How to Select the Right Health Care Plan for Your Needs

health care

doctor-1228627_640Health care is a hot topic these days, and everyone has an opinion on which company to purchase health insurance from. So, how do you wade through them all to decide on just one? Unfortunately, you do have to decide or face the tax penalty.?Here are some tips to help you select the right health care plan for your needs.

Check Your Current Coverage

Whether your current insurance plan is through your employer or privately purchased through the marketplace, coverages differ, so don?t be swayed by the opinion of someone else. To really know if you have a plan that works for you, find out the facts.

If you don?t know what your plan covers, ask. Get it in writing so you can reference it as you need to. Selecting the right health care plan for your needs is a personal decision. Everyone’s needs are different, which is why there are a variety of different plans available on the marketplace and at most employers too.

Compare Health Care Plans

If you?re insured through your employer and are thinking about making a plan change, check with the human resources department of your company to find out when and if you can make changes. There are usually certain times of the year, called Open Enrollment, when you can make changes to your health care plan and other benefits. Make sure to ask what, if any, changes you can make and the cost. Are there deductibles and co-insurance amounts to be met? If so, what are they? You are going to be receiving a lot of information, so I suggest you get a notebook and write everything down.

What do you do if your employer doesn?t offer health insurance? Check the Insurance Marketplace for your state. You can look it up online and find out what is available. Generally speaking, if the monthly premiums are less, the deductibles and co-insurance amounts are going to be higher. Conversely, if the monthly payment is more, the deductible and co-insurance amounts usually go down.

Now that you know what is available, compare the plans to see what fits your budget. Can you afford a higher premium in order to pay less out of pocket later if hospitalized? Or, are you fairly healthy and rarely require medical care? If so, maybe a lower premium is better for you. You must weigh these options to determine which health care plan is the best for you and your family.

Another favorite option is eHealthInsurance?- which allows you to compare plans and find the best one for your situation.

In Network and Out of Network

Many insurance plans have lists of which hospitals and doctors are accepted as belonging to their group of providers, in other words, in network. If the health care provider you prefer is not on the list, they are considered out of network and many times the bills you have from them will not be covered, or they will be covered at a lower rate.

Check the in network list?before you make a final decision on your health care plan to make sure the providers you see will be considered in network. If not, you might need to choose a different health care plan or find a new doctor to save money.

Read the Fine Print

Be wary of terms such as ?usual and customary? and ?reasonable and necessary.? These terms are a gray area and are an insurance company?s way of wriggling out of paying for a claim should you be hospitalized and have a large bill. If at all possible, stay away from plans with these gray areas.

Now that you know these basics, you should be able to avoid that penalty and make an informed decision about which health care plan is right for your needs.


How did you select your health care plan? Can you think of any other things people shopping for a health care plan should be aware of?


Photo courtesy of: valelopardo

The following two tabs change content below.

One comment

  1. Jamie says:

    I check with my doctor. The ability to retain my current doctor may be a deciding factor if I have a physician I do not want to lose.

Leave a Reply

Your email address will not be published. Required fields are marked *