How to Choose the Plan That’s Right for You

When it comes time to choose a medical insurance plan you may be faced with several choices. In some cases your employer will only have one plan or perhaps two plans for you to choose between, but in many instances you will be faced with several choices.

When it comes to health insurance, how do you know which health plan is best for you and your family?

Start by asking questions.

One of your first questions should be about your doctor. You will want to know if your family doctor is a member of the plan. If you are joining an HMO this is a particularly important question as you are not allowed to see a doctor who is not a member of the plan unless you have been admitted to a hospital emergency room. Even if you join a PPO or a POS plan seeing a doctor who is not a plan member will be far more expensive than seeing an in-plan doctor.

If seeing your own family doctor is important to you, then choosing a medical plan which allows this at a price you can afford will need to be a priority.

You will also want to know how the referral system works for each plan that you are considering. If you need to be referred to a specialist for any reason you will want a plan that makes such referrals fast and easy.

You’ll also need to ask about pre-existing conditions. Different plans handle pre-existing conditions in different ways. If you have a pre-existing condition how long will it be before that condition is covered?

What about traveling? How will your plan handle medical problems if you travel, both inside and outside the country?

Your next question should be about costs. Can your budget handle the premiums, the deductible, the co-payments and the coinsurance? Work out a worst-case scenario to see what your maximum cost for health care would be and make sure your budget can handle it.

Ask about plan maximums. What is the maximum payout in a year and the maximum over the life of the plan? Will that be enough for your situation?

There’s a lot you’ll want to know before you make a final decision on your health care. Don’t be afraid to ask questions – and demand clear answers.