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Comparing Health Insurance Plans in an Accurate Manner

Comparing Health Insurance Plans in an Accurate Manner

Once you have identified your particular needs so far as health insurance plans are concerned, it s time to make an accurate comparison between the options available to you. Since most of the companies offer you a host of plans, you not only have to decide on the right company for yourself, you will also have to select the right plan from that company. Here is a list of the various facts you might want to consider when you are comparing plans:

Member services you can avail

Many insurance companies provide members with special services. These can include anything between a nurse help hotline to educational classes for illnesses. Although these benefits are built into the plan you buy, the costs of such benefits also form a part of the premium you have to pay. Review these and find out whether they are relevant to you.

Hospital and physician network

This is one of the most frequent concerns people have. What doctors does my plan cover? Which are the hospitals I can avail of? These are frequent concerns. A number of doctors and hospitals enter into a contract with a number of insurance companies. If you have a doctor you regularly go to, you should find out what health insurance company he is under contract with. You might even get some ideas about the advantages of the various companies. You will also need to review the location you are currently at, its availability of hospitals, nursing homes and doctors. You may find that a few companies have the best selection of doctors in your area.

Premium costs and put of pocket expenses

Although you might find a plan that offers you more comprehensive covers, it is unrealistic to expect that the plan will cover 100%of all your costs. You might need to compare the premiums of a number of plans, to find out the one that is most suitable for you. Here are some points you might want to consider when you are choosing a plan:

How much do you have to pay for your own health care before your health plan starts covering you?

You can determine this by calculating the deductible you have to pay towards the plan for a year. Would you be able to pay this if you were hospitalized? You should also consider the savings you would make in premiums if you were paying a deductible. For instance, suppose you are considering two plans, one with a deductible level of $1000 and the other with a deductible level of $2000. You would probably save more on the latter plan if you were paying $100 more as monthly premiums on the former.

What are the costs you need to bear once the deductibles have been met?

There are two points you need to consider when you are answering this question- the coinsurance you have to pay and the maximum limits on the out of pocket costs you have to bear. This maximum level determines the point at which you stop paying coinsurance.

There may be special co payments for services like doctor services. Are these financially viable for you?

Obviously, this is something that will be decided by the number of doctor visits you make in a year. For most people, the limited amount they have to pay for doctor visits do not justify the hefty amounts charged as premiums for this facility. Talk to your doctor and find out about normal office visit charges. The biggest expense you make when you are going to a doctor is not his office fee. It is usually the lab tests you need to carry out. Except some HMO plans, most of the other plans will not consider these to be a part of the normal office visit.

Can you use doctors outside the network?

Find out whether your pan allows visits to doctor outside the network. HMO plans do not offer this facility, unless you are in a medical emergency. If your plan does support out of network visits, find out the coinsurance or copayments you have to make for each claim. Typically, you may find that the rates are quite high and there are limits to how much your pan will pay in out of network benefits in a year. Review these provisions very carefully, before you chose a plan for yourself.

What are the annual costs you have to bear for health services not covered by your plan?

If you have found a plan for yourself that offers you all the benefits you want, but not dental covers, you will need to consider that point too. Maybe you would prefer to pay out of pocket for such costs, or just buy a separate plan for it. These are usually minor considerations you will have to make, if the plan is otherwise suitable.

Are there limits on the amount that the carrier will spend on specific illnesses?

Be very careful when you are reviewing this aspect of the plan. You may have found a plan that offers you the lowest of premiums and the most suitable of benefits. It may also offer you the cheapest of copayment rates for doctor visits. Think- why the cheap rates? It might be because there is a ceiling on what the company is willing to pay for a particular treatment of yours. A hospital bill can run up to thousands of dollars. If your plan has a lifetime benefit ceiling of only a few thousand dollars, it will not be of great use to you when you need it the most. Some plans also limit the number of days you spend in the hospital, when they are paying for the costs. They may also impose a daily dollar ceiling on the amount they are willing to spend. Review the plan that is being offered to you very closely so that these are not the reasons for the low rates you are being offered.

Nobody can state with precision what their health care costs are going to be like in a particular year. If you could predict this, buying health insurance plan would be much simpler. However, you can use your past record to at least guess what you might expect to pay as health costs in a year. For unexpected injuries, make sure that your plan provides you cover for hospital stays. Also make sure that the costs you have to pay for the plan are within your budget. Private hospitals usually ask for proof that you are able to pay their bills, even before they admit you. A suitable insurance policy proves that you are able provide this proof when you need treatment.

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