It is not easy to choose a healthcare provider. There are many options and factors to consider. Can you pay the premium? Should you just go with what your employer is providing you? Does the plan include high out-of-pocket costs? Will it cover your dependents? These questions are all-too-familiar for those who have managed to determine the kind of health plan that they need. But what about those who are shopping for a policy for the first time?
Now more than ever, it is important to choose the best health care service provider. You should want a policy that has locum tenens healthcare providers available. In case your usual doctor isn’t available, you want to make sure someone will handle your medical needs. That’s the kind of assurance that you are looking for in a healthcare plan: its availability all the time.
Health Plan Marketplace
There are two places you can get health insurance from: the government insurance exchanges or the marketplace. If you are employed, your employer is your marketplace. But don’t be afraid to ask if you can get one from another provider, although your employer will only pay a portion of the premium. You can consider staying with your employer’s healthcare provider because the premiums are usually lower.
If your job doesn’t have health insurance, look in the marketplace for options. Start by looking at the premiums before the features of each plan. As much as you want the better plans, you should first be able to afford the premiums. There’s also the option of directly negotiating with an insurer, although you won’t be eligible for premium tax credits.
Generally, you should look at two things when comparing plans: the out-of-pocket costs and the types of doctors that you can see. For example, a health maintenance organization plan will have lower out-of-pocket costs, but less freedom to choose providers. You’ll have to stay in-network except for emergencies, and you need a referral from a primary doctor to see a specialist.
The three other types of healthcare plans are preferred provider organization, exclusive provider organization, and point of service plan. Each of these has pros and cons. Look at the out-of-pocket costs and the availability of doctors because these are the most telling features of a great health plan.
Do you have a doctor you prefer seeing? Check if they are the in-network providers of the healthcare policy you are eyeing. Otherwise, you have to transfer to another provider. If that is not an option, ask your doctors if they are part of any network. If you choose to see them outside your plan’s in-network providers, you’ll have to pay a higher cost.
You can also choose a plan with a big network of doctors, so you’ll have more options. This is especially important if you live far from the cities. You’ll likely find a doctor that’s in-network if you choose a plan with a large network.
Consider Out-of-pocket Costs
This is the most important factor to consider. The out-of-pocket costs of a plan will depend on how expensive the monthly premium is of that plan. In general, the higher the monthly premium, the lower the out-of-pocket costs. These are influenced by copayments, deductibles, and coinsurance.
So how should you choose the best plan according to out-of-pocket costs? You can choose a higher monthly premium with lower out-of-pocket costs if you see a doctor frequently, take expensive medication regularly, have a surgery coming up, and are suffering from a chronic medical condition, this is a good option for you, too. If you belong to any of these categories, you should choose a plan with lower-out of pocket costs even if you have to pay a more expensive monthly premium.
Talk to an Agent or Representative
Do you have any lingering questions about the plan? You should speak to a representative of the healthcare company, so your concerns can be addressed properly. Ask them about maternity benefits if you are pregnant now, for example. If you have a medical condition, ask what drugs are covered under the policy. Does the plan also cover health insurance abroad? These are important considerations when choosing which plan to get.
Once you collected all information and are ready to make a decision, write down the pros and cons of each plan. Review them again before deciding which health insurance plan is right for you. Check your financial status, too. Making sure that you can cover the premiums and out-of-pocket costs are essential to picking the right plan.