Choosing health insurance can be a difficult and frustrating decision for many people. With so many options, exclusions, confusing terms, and even political debates, it is very difficult to feel secure when choosing health insurance plans. Some of the best tips to get started on this complex decision process include examining current needs, assessing financial issues, and comparing plan coverage carefully.
While current health can't always be a predictor of future health, a person may be able to get a reasonable idea of his or her coverage needs from examining current and past medical issues. For instance, a person who rarely goes to the doctor and is not on any medication may prefer to choose a lower-cost insurance plan that offers limited or catastrophic coverage only. Families or individuals with regular health care needs may need to look for programs that offer more comprehensive care. If a person has a pre-existing medical condition, it may significantly decrease the amount of plans for which he or she is eligible.
Financial concerns are often paramount when choosing health insurance. Some plans have relatively low monthly premiums, but a high deductible that could lead to serious financial trouble in the event of an accident or sudden, severe illness. Other plans may feature low deductibles, but have a much higher monthly premium. Plans that include additional health coverage, such as dental or vision care, will generally be considerably more expensive than those which offer only basic medical, prescription drug, and emergency care. Striking the balance between need and financial capability is one of the most difficult parts of choosing health insurance.
Not all health plans are built the same way, so it is important to do some comparison shopping when choosing health insurance. Health management organizations (HMOs) are generally the cheapest options, but require that participants visit only in-network doctors, and do not cover visits to a specialist unless the patient has been referred by his or her primary doctor. Preferred provider organizations (PPOs) cover in-network specialist visits without a referral, and allow the participants to choose their own primary care physician. Point-of-Service (POS) plans are somewhat rare, and combine elements of both HMO and PPO plans. PPO and POS plans usually have higher premiums than HMO plans, but may be better for people who wish to choose their own doctors.
In addition to understanding how doctor visits are covered, it can help to understand what other services are covered or partially covered when choosing health insurance. Dental and vision care are frequently offered as add-on packages to a health care plan, each incurring an additional cost. Some plans may cover other types of medicine, such as chiropractic visits, acupuncture, birth control, or psychological services. Prescription drug coverage may also vary between plans; many less expensive plans only cover generic drugs, which may result in denied coverage of any drug for which a generic version does not exist.