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eLearning Series:
Your Most Popular Insurance Questions
Answers For Health and Home
Insurance
( 50 articles
in this series )
Choosing a
Medical & Health Insurance Plan
For Your Family
The abundance of available medical or health
care insurance plans on the market can make choosing a policy
and a provider an intimidating proposition. Consider the following
factors when searching for a health care plan that is appropriate
for the needs of your family.
Working
with a physician: many health care insurance providers
have a pool of doctors and health care professionals with whom
they are affiliated. You may be forced to find a new family
doctor if yours is not a member of this network. If you don’t
mind switching doctors, take care in choosing a new physician.
Ideally, see if a doctor in your area who has verifiable credentials
and accessible office or clinic hours services your insurance
plan. The American Medical Association can help you determine
a doctor’s legitimacy and in which hospitals and medical facilities
he or she has working privileges.
Access
to specialists: some plans limit coverage of fees associated
with consultations with medical specialists. Read the fine
print to see if your plan will pay for access to specialists.
This is especially important if you have, or anticipate having,
a particular condition that requires a specialist’s care. Similarly
to your family doctor, you may have to switch specialists if
yours is not part of the insurer’s established network. Though
common, OB-GYN care may be considered specialist care, so ask
specifically whether this service is available under your plan.
Fertility and pregnancy treatment are also areas that should
be addressed directly.
Pre-existing
conditions: verify that any pre-existing conditions
you have will be covered under a new plan before you sign.
You may experience a degree of flexibility on this point if
you are applying for employer-sponsored insurance, but you
will likely find greater resistance if you are applying for
private individual health insurance.
Emergency
care: your insurance provider may insist that you
go to only certain hospitals for emergency treatment, or that
you contact your family doctor before obtaining emergency care.
Have your provider define emergency so you aren’t left with
unpaid claims for emergency room visits for conditions that
don’t qualify for coverage.
Check
ups and screening: there is great variance between insurance
plans when it comes to check ups and screening. Determine if,
and how often, you can expect to be able to submit claims for
physicals and other preventative measures.
Medication: is it covered under your proposed health insurance
plan? Prescription drugs, particularly if required on an ongoing
basis, are expensive. Having prescription drug costs covered
as one of your health benefits can add up to substantial savings
over the years. If prescription medication is a benefit of
your plan, ask whether both brand and generic varieties are
covered.
Extras: additional services such as drug and alcohol rehabilitation,
counseling, home care, chiropractic, massage therapy, alternative
treatments and palliative or hospital care should be outlined
in your service agreement. With perhaps the exception of massage
therapy, no one likes to think about having to use services
such as these, but it is a good idea to have them included
in your health care policy if you are able to do so.
Fees: a health care insurance plan will help you manage the
costs of health care, but nearly all plans incorporate a fee
structure on top of the monthly premiums you pay. Fees may
come in the form of deductibles, percentages of services that
aren’t fully covered, or penalties if you do not comply with
your agreement (i.e. you seek care from a doctor that is not
affiliated with your insurer’s network). You may also have
to pay for care once you surpass a monthly, annual, or lifetime
limit on specific services. Find out what these limitations
are before you finalize the purchase of your health care insurance.
Exclusions: you will reduce the potential for rejected claims
if you have a clear idea of what your plan covers and what
it does not. There will always be grey areas, but for the most
part, you should know which claims are acceptable and which
will meet resistance.
Regardless of the plan you choose, the best health care plan
is still a preventative approach based on sound, moderate living.
Click here to to view health insurance quotes, compare plans side-by-side and apply for the most affordable health insurance within your budget. I did this myself (June 17, 2011) to change my health insurance policy. Saved me $84 per month (or $1,008 per year). It's my SolveYourProblem recommendation.
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by SolveYourProblem.com : 2005
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