YOU ASK:

How to evaluate your health care insurance plan?

WE ANSWER:

It is important that you evaluate your health care insurance plan to ensure that you have the best deal and that you get the plan you need. Here are some things you should consider:

  • Kind of plan.

    It is important to see what benefits a plan can offer you. There are a number of options. Individual health insurance plans, a health savings account or a Flexible Spending Account. A Health Savings Account or a Flexible Spending Account is like a savings plan is like a savings account for medical expenses. You get to save since the money you put in are tax exempt. You have to decide which of these plans will work best for you.

  • Kind of coverage.

    You should see what kind of benefits you need in an insurance plan. Check whether it has annual check-ups, preventive treatments, surgical coverage and routine screenings. Important benefits include coverage for prescription drugs, dental and vision coverage and even maternity coverage.

  • Total cost of the plan.

    The cost of the plan is not just the premiums. You will also have other out-of-pocket costs like deductibles and co-payments. Remember, though, that cheap premiums are not everything. You only get what you're willing to pay for, so if you want a more comprehensive coverage, you will have to pay higher premiums. You can also negotiate for higher deductibles so as to lower the premiums.

  • Width of the network.

    Check to see if the insurance provider has doctors and healthcare professionals that you would like to go to. For instance, HMOs are limited only to the providers in their network - you can't get treatment outside of the network. Preferred-Provider Organizations, on the other hand, allow you to go to other doctors, but you will have higher co-payments as penalty.

  • Exclusions.

    Check to see what the policy excludes. You may not be aware that they won't cover disease that you may have or may foresee having in the future. The usual exclusions are: optional or cosmetic surgery, substance abuse, injuries resulting in illegal activities, mental illness and alternative therapies.

You can make use of materials available - the insurance company's website, brochures and list of benefits will be helpful.

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