How to Compare Costs Across Private Health Plans

How to Compare Costs Across Private Health Plans

You and your family are currently without health insurance. You are self-employed and do not qualify for a group health insurance policy. There are so many options available to you, how do you know you are making the best decision for your family? Well, quite frankly, you won’t know if your decision is the best one, regardless of how much time you spend researching and shopping for a new family health insurance policy because all types of insurance are based on an unforeseeable risk and it is impossible to predict the future. In the case of family health insurance, you can analyze your family’s current health status and medical needs but will have no way of knowing what tomorrow will bring. To provide an example, let’s say that you want to have the most comprehensive family health plan available and the monthly premium is $600 per month. If your family remains perfectly healthy and has no medical claims during the year, you would have been better off with a low-cost, high-deductible health plan that would have allowed you to save money on your insurance premium, which could have been used for other family needs.

Determine Your Budget

The best way to find a health plan that meets the needs of your family is to first determine a monthly insurance premium amount that is affordable and then shop for the best plan in that price range. You will also want to make sure that the out-of-pocket maximum on any medical insurance policy would be achievable without causing severe financial hardship on the family. The annual out-of-pocket maximum is the maximum amount that you will contribute toward your health care costs in the worst-case scenario. Once you have reached your out-of-pocket maximum, your insurance company will pay 100% of all covered medical expenses for the remainder of the calendar year. To determine if you are purchasing adequate health insurance for your family, add the out-of-pocket maximum to the annual premium total. Now, look at this amount and decide if this total possible expenditure would be attainable based on your current savings and income. If it is not, you need to find a plan with a lower out-of-pocket maximum or lower monthly premium. Keep in mind that the out-of-pocket maximum is often directly related to the premium amount, so it may be a challenge to find the right combination because as you lower the out-of-pocket maximum, you raise the monthly premium. The primary purpose of health insurance is to protect your family against financial disaster in the event of an unexpected illness or injury. If the health plan you are considering does not accomplish this, you are probably looking at the wrong plan.

Find the Right Company & Plan – Don’t Be Intimidated by Agents

Once you have decided what a comfortable maximum is for your annual family health care costs, it is time to find the right insurance company and the plan that meets that budget. There are many sources online that provide health insurance quotes from multiple insurance companies. Other online sources will ask for your information and forward this to one or more agents that sell health insurance in your state. Many people are intimated by the prospect of having to talk with an insurance agent because they fear they will be forced to purchase something that they later regret. Don’t be afraid, be smart!! Don’t let an insurance salesman force you into purchasing a policy that you are not absolutely certain is a good health plan for your family. Don’t rush into this decision and purchase the first policy that looks attractive. Do your research, find out about the insurance company, verify that your doctors accept the coverage and get a second opinion. Insurance premiums are determined by the insurance companies and these can’t be modified by your insurance agent. So, once you decide which plan you want, there is no need to shop the cost of that plan with several agents. Purchase the policy through an agent that you like and have a good feeling about working with. We all know that insurance salespeople have a reputation for being pushy. Don’t let them intimidate you. It is your decision, so you are in control. If you need to get rid of a persistent agent, simply tell them that you found a new job and your employer will be paying 100% of your health insurance through the group plan. That’s an impossible objection for them to overcome and will work 95% of the time.

Consult With Your Doctor

While you are shopping for family health insurance, you will learn that most insurance companies have several different plan options to choose from. Your larger insurance companies should have a plan option that meets the financial and health care needs of just about every family. You may find it easier to first choose which insurance company you want as your health insurance carrier, and then find the best plan in their portfolio for your family’s needs. If you have a regular family physician, trying to ask him which insurance companies he accepts and which he prefers working with. Since the relationship between your doctor and insurance company is an important factor in efficiently managing your family’s health care needs, his opinion is invaluable. Your doctor’s office should be able to tell you which insurance companies are best about paying claims and authorizing treatments when necessary. Consult with each family member’s physician regarding their insurance carrier preference. You want to make sure that the insurance company you select has a relationship with all of your family doctors. Having access to the negotiated rates offered by participating in-network physicians can greatly reduce your family’s out-of-pocket health care expenses and will also allow you to receive the maximum benefits offered under your health plan.