Health insurance is essential for most people (unless you have a lot of money lying around and don’t mind spending it when emergencies strike). You need it for everything from routine checkups to invasive surgeries.
Unfortunately, shopping for health insurance is challenging. The industry is archaic and complicated, and you never quite know what you’re going to get without reading all the small print.
For this reason, we’ve written this post. We take a look at some of the things you need to do when shopping for a decent health insurance product to ensure it suits your lifestyle and preferences.
Here’s everything you need to know:
Know Your Health Needs And Priorities
The first step is to better understand your health needs and priorities. Knowing what type of insurance you require is essential if you want to bring costs down and benefit from value for money.
Consider your future healthcare needs, such as pregnancy or preventive care. Try to work out what conditions you are likely to develop based on your lifestyle, family history, genetics, and previous diseases and conditions. Look for services that meet these requirements without any of the fluff you don’t need.
Compare Monthly Premiums To Out-Of-Pocket Costs
The next step is to compare your monthly premiums to out-of-pocket costs. You may find that your healthcare expenses are significantly lower than you thought. In these situations, you’ll need to weigh up the risks of not taking out insurance and instead relying on savings to pay for healthcare if something goes wrong.
When considering the costs of each approach, look at co-pays, premiums, and deductibles. Try to find out whether it is worth taking out insurance or if a better strategy would be investing money and then using it if you develop symptoms. In most cases, the latter option will make you better off, but it is also riskier.
Also, be sure your monthly premiums cover the services you need. Many insurance companies will cover acute illnesses, but not chronic diseases.
Look At The Extras
Experienced health insurance consumers also look at the extras that come with their policies. Additional perks can often mean the difference between a policy being worthwhile and useless.
What those extras are differs from one carrier to another. For example, some plans include dental coverage while others offer vision care or mental health services. You’ll want to consider which of these is most beneficial for you.
Also, check any existing policies to see if they cover these optional extras. You may find that you have access to vision care already through an employer or another type of insurance you have. Don’t pay twice for the same coverage. Instead, pay for a more basic cover with a lower premium.
Get Quotes From Multiple Sources
When shopping for health insurance, you also want to get quotes from multiple sources. Being able to compare prices lets you find the best deal.
Many consumers use health insurance software to help them with this. Applications speed up search and make it easier to see the best deals and compare them to each other.
If you want, you can also consult with independent insurance brokers. These professionals can help you find the cheapest deals, getting their commission from the other side.
Research Insurance Company Reputations
You’ll also want to spend a little time researching insurance company reputation. Even if you find a provider offering a lower price, it might not be what you expect when you come to claim. Many carriers employ devious tactics and harmful small print to prevent you from accessing funds when you need them.
The best way to learn about the quality of a health insurance provider is to read their reviews online and find out how they treat their customers. Ideally, you want insurers who pay out in legitimate cases. You don’t want companies that hoard as much cash as possible, just to push down premiums.
If you notice a company has a good reputation, pay a little extra on the premium for peace of mind. After all, you don’t want to make dozens of payments only to discover your unscrupulous insurer is refusing to pay out.
Sign Up During Open Enrollment
Another tactic when shopping for health insurance is to sign up during open enrollment, usually during the fall. Buying at this time makes it more straightforward to switch from your existing provider and get a great deal on a new plan.
Don’t rush it, though. Take your time to decide which option will be best for you and your family. Try to find out what each policy covers and which might benefit you the most, given your current situation.
If you have a good broker, they should be able to track changes in pricing and perks over this period, alerting you if the situation changes. You may be able to get more for your money by taking this approach.
Check Drug Coverage
Shopping for health insurance also requires checking for drug coverage. You need to ensure the carrier covers the medication you need.
You may find that some insurers use formulary tiers. These determine co-pays for various types of medication, which can become expensive over time.
If possible, ask the insurer whether they offer discounts for mailed or generic drugs. You may find you can access lower prices this way instead of paying high premiums for the branded options.
Don’t forget to also consider drugs you might need in the future. Ideally, the insurer should offer these at cost-effective prices.
Compare Various Plan Types
You should also be making a habit of comparing various plan types. You may need your policy to be PPO or HMO-compatible to benefit from everything the scheme offers in your area.
Unfortunately, the complexity of the medical system means that every plan is different. Each has a network of providers and cost-sharing arrangements you’ll need to consider before you start paying premiums. Don’t lock yourself into a plan that doesn’t meet your needs or enable you to access treatment locally.
You’ll also need to consider your budget. While premium plans are attractive, they can wind up costing a fortune over the long term without offering any real benefits.
Check Provider Networks
We also recommend checking provider networks to ensure the health policy you choose operates in your region. Most insurers operate a patchwork of services, allowing them to maximize revenues while avoiding competition with companies in control of neighboring districts.
When checking service levels, go beyond simply asking whether an operator is active in your area. Also, ensure that they provide the level of service you require for your condition or illness. Make sure they field the relevant specialists and you can access the equipment you need to manage or overcome your health condition.
Check carefully the small print. Many healthcare providers will make generic statements about providing you with medically necessary treatments, but they might not be available at the clinics that are part of the scheme. That fact could bar you from getting the better treatment you could have obtained if you had gone to another provider.
Get Professional Help
You might also need to get professional help to choose an insurance provider if you have complex medical needs. Knowing which providers meet your unique challenges can be of great help long-term, as it makes it more likely that you will get the care you require.
Nurses and health advocates are some of the best people to choose to assist you. These individuals understand the market and your health care requirements, directing you towards policies that will support your well-being long-term.
Professionals can also help you understand the options open to you to make an informed decision. By explaining everything to you, they instantly make you feel more confident.
Only Buy The Cover You Can Afford
While some premium plans might look attractive, it’s critical to only buy the cover you can afford. Paying for more than you need can hurt you financially and still force you into debt when it comes to paying deductibles and copays.
Negotiate With Insurance Companies
You might also try negotiating with insurance companies to see if they will give you a better deal. Things that might get them to lower the price include:
- A history of making insurance payments on time
- Asking for less coverage and eliminating items you don’t think you’ll need
- Displaying health-promoting behaviors and characteristics
- Being eligible for government assistance
We suggest trying each of these methods in turn to see whether you can present yourself as a lower-risk customer.
Keep Up To Date With Plan Changes
Finally, it’s a good idea to stay up to date with plan changes. Insurers will sometimes adjust their terms and conditions to make their policies more or less beneficial.
The most straightforward way to stay up to date is to sign up for various email lists. Insurers should keep you informed of any changes to their policies, but you’ll need to wade your way through all the small print to discover any unfavorable alterations.