Before choosing health insurance, a person needs to know what he or she needs. Many plans are similar, but there are small differences in what they cover and how much they cost. Most insurance companies have the same deductibles and cover all the usual, everyday health problems. Some plans cost more and make the insured pay for more costs, but they give the insured a wider range of control. Some plans are made for people who want to save money, so they have more restrictions but cost less. So think about what you need for your health and how often you need to see a doctor. Make sure your doctor is willing to help you get referrals when you need them. Here are some things to consider when choosing the best plan for you.
What benefits does the insured get from the plan? Most plans cover normal health care costs. But find out what other services you might need and how easy it is to get them, if at all. Make sure you know if you will have to pay extra money if you see certain types of doctors or other medical professionals. Does this plan have any rules about pre-existing conditions or long-term illnesses that could lead to a higher premium or co-pay in the future? Make sure you know what you're getting and that it works for you. If you aren't sure, call the company and talk to someone who can answer all your questions.
Health screenings and physical exams as a way to get into a plan. Does this work for you, and do you not want to tell them about your health problems before you get a quote? Many insurance companies want you to see one of their doctors to make sure you don't have any long-term illnesses that will cost them money. If you have health problems that need to be seen and treated often, you might not want to look to these companies for help with coverage.
Care from experts. If you need care from a specialist, like a cardiologist, a nutritionist for diabetes or obesity, or any other kind, you should make sure that this is fully covered by the plan you choose. You don't want to sign up for an affordable plan only to find out that you can't see the doctors you need to. Make sure you look at all the information about coverage that goes beyond just the basics.
Care in a hospital or in an emergency. Before you can go to the hospital, most HMOs need a note from your primary care doctor. Some insurance companies won't pay for hospital visits on the weekend if you didn't call your doctor first and get a referral. Some will even make you wait until the next business day to see your doctor if it's not a life-or-death situation. If you have health problems that could send you to the hospital, make sure your policy covers you. When you're having a panic attack, it's not a good idea to wait for the person "on call" to call you back, give permission, and call the hospital for you. You need to know that you can call for emergency care and get a referral the next business day.
How will the company pay for prescription drugs? You could think about how many prescriptions you need and how much each one will cost. If you are used to paying small co-pays, having to pay 20% of a $150 prescription can be a slap in the face. Many people who take daily medications will benefit more from an HMO with a small fee, like $5 or $10 per prescription, and/or a small deductible.
Care for the eyes and teeth. Check to see if these are part of your plan or if you need to buy one or both of them separately. Many plans will cover eye exams and visits once a year or in case of an emergency. Also, a lot of them have some coverage for glasses. Most dental plans are separate and need to be paid for with separate insurance or a slightly higher monthly fee.