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In order to best serve yourself, you should first know what a typical health insurance policy covers, what questions you should ask your provider in terms of the policy, how to get the lowest possible premiums, clauses and small print to watch out for before signing any papers, and what additional coverage you may need to consider aside from the standards.
What is Covered By a Typical Policy?
When it comes to health insurance, there are a number of variations in coverage. However, a very basic health care plan covers one well care visit per year per covered individual as a check up procedure, as well as visits to your primary care physician as needed for illness and injury.
These all incur a co pay that is determined by the plan for which you sign up, and your deductible may come into play with certain types of policies, having to be met each year. Some procedures are covered, such as pap smears (twice a year) and prostate exams (annually, based on age) or mammograms (annually, also based on age).
Different types of plans will cover health care differently. For example, an HMO plan, one of 3 different managed care type plans, consists of a network of doctors. You will pick a primary care physician within your network, and any specialists will have to be based on this doctor's referral.
A POS, or Point of Service, plan will allow your doctor to refer you out of network for the same coverage as if you were to choose a specialist within the network for yourself.
With a PPO, you can see whoever you want, in or out of network, without a referral and just a small financial penalty for going out of network.
Medicare, Medicaid, and State Children's Health Care provisions are highly regulated by the government and will cover the cost of medications, surgeries, hospitalization, and some skilled nursing care.
What Should I Ask My Provider?
Before you determine which health insurance plan is best for you, consider some questions that you should ask your provider:
* What is the annual out-of-pocket maximum? You don't want to end up spending a fortune if you frequently go to the doctor.
* What is my co pay? You want to know what you will pay for medications, doctor visits, and emergency room care.
* What is my premium? What will you pay monthly for this coverage?
* What sort of child immunization/pregnancy/birth coverage is offered? Know your family statistics before you choose a plan.
* What clauses are there regarding pre-existing conditions? Make sure you know what will and won't be covered based on your former coverage.
How Can I Save Money and Reduce My Premium?
Several options can help you reduce the premium on your health insurance; however, you have to weigh the value of doing so because most decisions are a trade off. First, shop around and find the best value. Don't choose the first policy you research because it may be overpriced. From there, it all depends on what you are willing to give up.
* Raise your co pay. When you pay more up front for the prescription or the doctor's visit, your policy doles out less money, which means that your premium will be lower. Remember, though, that you'll be paying more every time you go to the doctor or fill a prescription.
* Opt for higher deductibles. Are you relatively certain you won't run into a situation where your deductible will need to be met prior to coverage being enacted (such as hospital stays and emergency care)? If so, you may be willing to risk a much higher deductible so that your premium is greatly reduced.
* Don't opt for extras. If there are options for additional services, opt out of them to save a little cash.
Read Between the Lines:
Pay attention to the fine print of any health insurance policy in which you intend to enter. There may be clauses regarding pre-existing conditions that are not conducive to your life, and you may find that the provider reserves the right to raise your premium without notice or reason (such as rising industry costs). Be sure you know what your contract says, and you'll be able to save yourself a lot of hassle and pain in the future.
Other Coverage You May Consider:
In terms of health insurance, there are different options you may consider, such as a flex spending plan, health savings account, or other indemnity plan. You might also want to consider purchasing a package that includes dental and vision insurance or perhaps even life insurance, since you will find that purchasing multiple policies from the same provider often results in discounts in premiums.