When researching health coverage, it is very important to be aware of your overall needs. Many benefit plans are similar, yet have slight variations in coverage and expense. Most health coverage companies offer similar premiums, deductibles and cover all the standard routine issues that arise in health.
While some plans may seem less expensive, they usually have a high deductible, as well as additional upfront costs when a claim is started. Some plans are designed for those who want more control, they may be more expensive upfront, but offer more protection in case something does happen. It’s important to have a budget in mind, as well as be aware of what additional benefits could be offered to you through your policy.
Usually the best coverage that money can buy may include things like income protector, dental, vision, life insurance, accident protection, and regular doctor visits. If you are looking for basic coverage, you may go with a less robust plan, that is more affordable. Most people are looking for something in the middle, with good overall protection, at an affordable cost.
Here is a list of what benefits and additional coverage to look for:
1) What are your policy’s benefits? How many doctor’s visits are you allowed per year? Does it cover accidents and sickness? Most plans provide normal medical coverage, but pay attention to what other services you may need and if they are easily available.
Make sure that you are well informed of any upfront costs when you visit doctors or other medical professionals. Does your plan have restrictions or exclusions on pre-existing conditions or chronic illnesses that could cause a premium increase or higher co-pay down the road? Know what you are getting and make sure that it works for you. If you aren’t sure what you are getting to, or find yourself overwhelmed by the information, its important to reach out to a licensed health agent who can make your experience much quicker and easier.
Medical doctor, specialists and health screenings
2) Does your plan cover you if you see other medical doctors and specialists? If you require the care of a specialist, such as a cardiologist, dermatologist, chiropractor, nutritionist, or any other type of specialist, you want to make sure that it will be fully covered. The last thing you need is to sign up for a plan that is within your price range, yet doesn’t cover the doctors you need to see. Be sure to see all the information on added benefits and coverage above and beyond just basic needs.
3) Does your health coverage require physical exams or health screenings? This may or may not be something that you are open to if you do not want to disclose your medical history prior to getting a quote. Some insurance companies may require medical records, or ask you to be seen by one of their physicians to check for major chronic illnesses.
If you are a relatively healthy person, don’t take a lot of prescription medications, and rarely visit the doctor, you may possibly qualify for a more affordable plan if they request your medical records. In addition, when you are in overall good health, some companies will place you in a pool with other healthy individuals to keep your cost relatively low with great coverage.
On the other hand, if you have medical conditions that require frequent doctor visits, medications, or expensive treatments you may not want to disclose your health history and instead look for health benefit providers who offer you coverage regardless of pre-existing conditions.
Does your plan cover emergency care & prescription drugs?
4) Hospitalization and emergency care. Most HMOs require a referral from your primary care doctor before you may go to the hospital. Some insurance companies will not pay for hospital visits on the weekends, unless the doctor was called in and gave the referral prior to you going. Some will even require that you wait till the next available business day to see your doctor first if it isn’t a life or death emergency. If you have conditions that might require a trip to the hospital, be sure that your policy works for you. When you are in the middle of a panic attack is not a good time to wait for the “on-call” service to call you back, and give you permission to go in for a visit . You need to know that you are allowed to call and get emergency care as soon as you need it, not when the insurance thinks that it is convenient.
5) Prescription drugs and what will the insurance company pay for? You might want to take into account how many prescriptions you need and what the cost of each one is. If you are used to a small co-pay, it can be a big surprise to find out you have to pay 20% of a $150 prescription. Many people who require lots of daily medications will benefit more from a plan that has a small fee for medication like $5 or $10 per prescription and/or a small deductible.
Is Vision and Dental Health Coverage Included?
6) Vision care and dental services. Find out if these are included in your health insurance plan or whether you need to purchase one or both separately. Many plans will include yearly and emergency eye exams and visits. Also many offer some coverage on eye wear or contacts, double check and pay attention to what is included. Most dental plans are separate and require a separate insurance or slightly higher monthly fee to be added.