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11 things to check for when choosing a new insurance plan

2nd April 2020 Print

Health insurance has been a hot topic for many years. Finding the right plan and being able to afford it has become a challenge for most people, but we all need health insurance to keep our bodies up and running without all the costly bills.

Here are 10 of our best tips to help you find an affordable health insurance plan that you'll love.

Know What Type Of Plan Works for You

There are two main types of health insurance plans that are offered. These are indemnity health insurance and managed care. 

Indemnity health insurance plans are commonly referred to as fee-for-service plans where you pay a percentage of the costs for medical services. The insurance company will pay the remaining balance and you'll typically have access to picking your own doctors.

Managed health insurance care plans are broken down into a health maintenance organization (HMO) or a preferred provider organization (PPO). This type of plan allows you to have small out of pocket expenses. However, you typically have to see doctors in the network for your insurance to cover the costs.

Look for Doctor Authorizations

It's very important that you understand whether or not your new insurance plan will cover seeing your existing doctors. Some plans may limit your coverage to doctors only in their network. If you go outside of the network, you're typically responsible for paying the entire bill. 

You'll also want to check whether or not you'll need to have a referral to see a specialist. Some insurance companies will require a referral from a primary physician before they will cover the costs of an appointment with a specialist.

Know the Deductible

Many health insurance plans require you to pay a set amount of money towards your medical services before your insurance coverage will kick in. Depending on the specific policies of the insurance provider, they may cover annual wellness visits before the deductible is paid. 

With others, you may have to pay the entire deductible before any sort of insurance coverage kicks in. It's best to know where you stand with potential providers before agreeing to use one.

Know What Benefits Are Included

Various health insurance plans will cover an array of benefits. Some of the most popular are dental, vision, prescription, and specialty care services. It's best to know what's included and what's not included in your plan. 

This way, you can determine whether or not you want to combine multiple health insurance plans so that you're covered for a variety of benefit areas. In some cases, you may find that you're better off paying cash for some benefits that you don't use often.

Ask if Pre-Existing Conditions Will Be Covered

Pre-existing conditions are a tough area when it comes to health insurance. Some providers won't give you any sort of coverage for medical expenses related to pre-existing conditions. Others may require you to have a policy for a set amount of time before they will cover any expenses related to pre-existing conditions. 

If you know that you have a chronic health condition, you'll need to be upfront with the insurance agency to learn what their coverages are and what their limitations are on treatment.

Understand Coverage When You're Away From Home

Sometimes medical emergencies happen. Therefore, it's important that you understand what your coverage limitations are when you're away from home. 

Many insurance providers will give you two scenarios. They'll explain what you're covered for when you're still in your domestic territory and also what you're covered for when you're in international territory.

In most international cases, expect to be reimbursed by your insurance provider up to their coverage limits, as most international doctors and hospitals won't take your insurance. When it comes to domestic emergency cases, such as traveling outside of the state, your health insurance in Florida will likely be accepted in the state of Pennsylvania.

Check the Premium

The premium is defined as the amount of money you pay each month for the plan. Some insurance providers may have bi-annual premiums where you pay a lump sum every six months. Most, however, will charge a monthly premium that you'll be locked into paying for a set term length. Most health insurance terms run six months to a year.

Know What Pharmacies You Can Use

Most health insurance programs will have some sort of coverage when it comes to prescription medication. Understanding what pharmacies you can use is a necessity. 

Some plans will restrict you to only use certain pharmacies to get your prescription medications. Other plans may allow you to utilize any pharmacy. In addition, you'll want to know what you'll have to pay on average for prescription medications, too.

See If Your Plan Covers Routine Checkups

Most health insurance policies must cover some form of annual checkups for their patients. These include things like physical examinations, OB visits, and flu shots. You should understand what's covered when it comes to regular immunizations and checkups so you can take advantage of them each year to get the most out of your plan.

Understand What Happens If Your Employment Changes

You always want to verify what will happen with your insurance coverage if you get a new job. Some insurance providers may void policies when you switch jobs without informing you. It's best to have a good idea of what will be expected from you in the event that you switch jobs when you're in the middle of a policy coverage term.

Do Your Research

You should always do your research before deciding on a new insurance plan. There are many options out there that work, but to get the most out of your money and to ensure you’re covered when health problems arise, take the time to learn more about each plan before making a choice.