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Health insurance choices

How to decide which plan to buy

Once attorneys are involved in writing the Plan, most are often difficult to understand. But, if you are to find the health insurance plan that offers the best cover at the premium rate offered, there’s no choice. You have to read through the Plans. So what should you look for? The best approach is to make a list for each Plan on offer:

What is the premium rate?

Look carefully at whether you can afford the rate quoted. It can damage your credit rating if you take on a financial obligation and then default.

What is the deductible?

Agreeing to a higher deductible earns you impressive discounts but ask yourself whether you can afford these cash payments should you be unlucky and fall ill. Unfortunately, out-of-pocket medical expenses can add up quickly. As with the premium rate, do not agree to a high deductible unless you are sure you can afford to pay.

What is covered?

The gold-plated plans cover almost every possible disease and disorder. The cheaper only cover the more serious and expensive problems that are relatively rare. Check whether the plan covers the particular services you think it likely you may want to use. For example, do you have an existing condition that will need continuing attention? Will the plan pay for managing a pregnancy and delivering the baby? and so on.

How much choice do you have?

In some plans, you are limited to a specific primary care physician and, if you go outside the network, you pay all the bills. You need to look at how easily you can change your primary care doctor if you do not get on, and whether you have any flexibility when it comes to using doctors and hospitals outside the network.

What prescription medications are included?

This often reflects limits imposed because of pre-existing conditions and your long-term need for repeat prescriptions. So, if you are asthmatic or suffer from allergies, check the relevant list of drugs to see whether all the cost is covered. If not, are the co-payments affordable? Also check how often the co-payment element can be raised.

What are the limits should there be an emergency?

Some times, an emergency can arise and the ambulance takes you to a hospital not in your network. Equally, what happens if there’s an emergency while you are on holiday outside the state? If you are abroad, pay particular attention to how you get home.


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