Selecting the right health care plan can be complex. You have many lifestyle factors to consider, including your age, health history, family status, anticipated health care costs and budget. How can you be sure you’re choosing the right plan? Here are four steps to finding health care that works for you.
1. Choose Your Marketplace
Many employers offer health care insurance as part of a benefits package. If this is true for you, then you can probably save money by choosing an option from your available work plans. Most employers pay part of the insurance premiums for you.
If you want to choose an alternative plan in the marketplace, or if your employer does not offer insurance, you can choose from the federal exchange, state exchange if available, or through a private insurer. Suppose you are on a budget and using money-saving strategies in other areas, such as a velocity banking strategy. In that case, you may want to consider federal or state insurance to stretch your money further. Choosing a private insurer means you won’t be eligible for premium tax credits.
2. Compare Plan Types
When it comes to choosing the type of health care plan you need, your lifestyle has a lot of influence. If you have a spouse and dependents who need coverage, for example, you need to factor in their projected medical costs along with yours. You can base your projections on past medical treatments and expenses.
It may seem tempting to roll over your previous plan without reevaluation — especially if your plan defaults to the existing one if you do nothing. Plans generally change each year, however, and new insurers join the marketplace. Your current insurance may even have revisions that affect your coverage and cost.
If your lifestyle has changed recently through marriage, death, divorce or a new job, or if you anticipate changes such as the adoption or birth of a child, you will need to scrutinize your plan choices. If you have a spouse with available coverage through an employer, it’s best to review those plan options to see if they are a better fit for you.
3. Pay Attention to Out-of-Pocket Costs
Monthly premiums are essential to consider when comparing plan costs but don’t forget to factor in other expenses such as deductibles and co-payments. By factoring in additional charges, you can broaden your research to include anticipated yearly fees. The big picture can sometimes help you narrow down your choices if you’re stuck between two plans.
Your lifestyle affects your out-of-pocket costs. You may better off with a plan that pays a higher portion of your expenses but has a higher monthly premium if you or your dependents:
- Make frequent doctor visits
- Take expensive or brand-name medications
- Plan to have surgery
- Live with a chronic condition
A plan with a lower monthly premium and higher out-of-pocket costs can be better if you are in good health, make few doctor visits or can’t fit a high monthly premium into your budget.
Checking coverage for specific medications or conditions can help you narrow down your choices further. If you have diabetes, for example, try to find a plan that covers your prescriptions. If you’re expecting a baby, compare maternity services between plans.
4. Ask Questions
If you have specific concerns or questions about a plan, don’t hesitate to pick up the phone and call a representative. Your employer’s human resources department can help you or direct you to someone who can. If you’re shopping for a plan in the federal or state marketplace, you can find help from an agent or assistant. Understanding your plan is imperative — you don’t want to wait to ask questions during an emergency.
Choosing a health care plan that fits your lifestyle is complex, but it’s doable with research, planning and assistance if you need it. Your health is worth the extra work you put into finding the right plan.