Health Insurance

How do I know what health coverage to buy?

A Answers (2)

  • Think about your needs and ask:
    Do you want a plan that covers preventive care like annual check-ups? Most fee-for-service plans don't cover these visits, but managed care plans do. This aspect is particularly important if you have or are planning to have children.

    How healthy are you? If you need a low premium and are healthy, consider a high-deductible plan. Understand, though, that accidents happen, and a single hospital stay could wipe out your savings and plunge you into debt. Think about how much money you'd be able to apply to medical expenses if necessary.

    Do you have a specific doctor or hospital in mind? Managed care plans use networks of doctors, and if your doctor isn't in that network you'll pay some or all of the bills if you see him or her. If specific providers are necessary, consider a fee-for-service plan.

    How important is easy access to specialists? Many managed care plans require a referral from a primary care physician before you see a specialist. If they don't feel it's necessary, you'll pay for the visit out-of-pocket.
  • Review your health care costs and try to estimate how much you spend on health care and how much you may spend in the coming year. Some health plans have tools to help you estimate your costs. Remember to factor in doctor's visits, prescription medications and procedures. After you have estimated how much you expect to spend, make a list of the out-of-pocket expenses, premiums and benefits of each plan you're considering. These can include co-payments, deductibles and fees for seeing specialists. Many health plans establish provider networks that include doctors, hospitals and other health care providers who have contracted with the health plan to provide care at special rates. You will also need to factor in the costs of using an out-of-network doctor or other health care provider you choose that is not in the plan's network. You should check to see if your doctor is included in the plan's network. 
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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