The key to finding the right health insurance is to find coverage that is appropriate to your needs. Not all health insurance plans are created equal, and not all plans are right for everyone. Some people have a much greater need for prescription coverage and doctor’s office visit coverage. Some people have a much greater need for accident or catastrophic insurance.
Generally speaking, if you need a traditional health insurance plan, one with co-pays for doctor’s office visits and prescriptions, you will be paying quite a bit in premiums. The features of this plan that are important to pay attention to are the deductibles, co-insurance and co-pays.
Deductibles: The higher the deductible, the lower the monthly premium. However, this can be a dangerous gamble, if the deductible is over $500. Statistically, most medical insurance claims are under $5,000. If you are not going to the doctor frequently or filling costly prescriptions, having a high deductible plan is a bad gamble.
Co-insurance: This term generally refers to the percentage of the hospital bill that you are responsible for. Many medical plans are 80/20, meaning that the patient is responsible for 20% of the bill. It is very important to understand this and to find a medical plan that puts a hard dollar limit on your maximum out of pocket amount on the 20%. For example, even though 20% of the bill comes to $15,000, your plan has a $5,000 stop loss, limiting your out of pocket exposure to a maximum of $5,000.
Prescriptions: Many individual health plans on the market today have a separate deductible for brand name prescriptions. While it is true that most prescriptions are available generically, some important drugs are not, and these can be very costly if you have to pay the first $500 every year of your brand name prescriptions. Take into consideration what prescriptions you are on and if they are available generically when looking at health coverage.
Co-pays: The co-pays are the small upfront charges that you pay for an office visit or to fill a prescription. It is important to understand and know what co-pays apply to what situation. For example, some plans have separate office visit,lab work and x-ray co-pays, some plans just have a general office visit co-pay that includes x-rays and lab work
Now, the fact that most medical claims are under $5,000 can work in your favor if your are just insuring yourself and if you are healthy and not on any prescriptions. There are a number of limited benefit health plans available that have no deductible, pay out a set amount for specific procedures and situations, and are very affordable. These plans can save a large amount of money in premiums and deductibles. Again, not all plans are created equal, and you should consider a number of factors before choosing a health insurance plan. You should find a plan that suits your situation and budget.