With the recently passed health care reform legislation, millions of Americans will find themselves having to “purchase” health care coverage. Whether you’re getting coverage for the first time, evaluating Medicare options, shopping for individual insurance, or choosing a plan from options offered by your employer, the process can be complicated and confusing. Start by evaluating the following:
Your Budget
Even if you qualify for a subsidy, determine how much you can pay for health care on an annual basis. Questions to ask yourself:
- Who will be on the plan? Just you? You and a spouse? What about children? The new bill allows for adult children up to age 26 to stay on a parent’s plan. This decision affects premium rates.
- Which works better for you: a lower monthly premium with an upfront deductible or a higher premium with no upfront deductible?
- What about co-pays? If you go to the doctor frequently, you might want a plan with lower co-pays, a higher monthly premium and little, to no, upfront deductible.
- Think in terms of surgery and preventative care (physicals, colonoscopy, etc). Check the plan for out-of-pocket (meaning your dollars) costs for these services. Many benefit plans include preventative services. Explore this carefully as it could have significant impact when you need care.
The Network
Once you’ve determined budget issues, consider the network. Make a list of all the doctors and health care providers you and your covered family members have seen in the last 12 months. If you currently have coverage, register for and use the plan’s website to review your claims history. Using this information, assess your needs by answering these questions:
- Do see certain primary care or specialty doctors on a regular basis?
- Do you prefer a particular hospital?
- Do you want to be able to obtain second opinions outside of your local area? If so, you might want a health plan that includes some level of coverage for non participating doctors.
When evaluating your needs, be sure to include health care professionals such as physical therapists, chiropractors or optometrists.
Next week Health Champion will explain how to evaluate benefit designs. If you have any questions — or issues you’d like covered — please leave a comment and we’ll address your concerns in an upcoming blog.
I always learn something new
I feel like I’m constantly looking for interesting things to read about a variety of subjects, but I manage to include your blog among my reads every day because you have honest entries that I look forward to. Here’s hoping there’s a lot more great material coming!
good post, just bookmarked, first time drop in here, greeting from Japan.