A very significant decision you will make in life is choosing the right medical plan. Obtaining the most essential medical care can improve the quality of your life or save your life. These are the 5 things you should know before taking health insurance.
1. The first and primary factor to consider is your health. The doctors in the plan will have the most impact on your well being. You’ll want your ensure your primary care physician (PCP) is an approved doctor and women will want to also check for their gynecologist. Your PCP can also advise you which companies have the most flexible plan administrators. The specialists associated with the HMO will be crucial in your decision making if you have a serious medical condition and/or have a family history with significant health issues.
2. Of course, the costs associated with the plans will be a key element in our decision. It will be easy to compare the monthly cost of the insurance for you and your family. You will also need to compare the copays. Some plans have higher copays for specialists. Other expenses to check are deductibles for tests and hospital stays. A much overlooked financial factor is the annual maximum out of pocket cost. This is the highest amount of cash you have to pay per calendar year for all medical expenses. Any remaining out of pocket expenses are waived until next year.
3. The third thing you should review is the prescription section of the health insurance plans. There are a number of different factors which could alter your decision. Some plans require you to use only generic drugs unless your doctor receives specific permission to prescribe a brand name drug. Most plans have different copays for generic drugs versus preferred brand name versus brand name. Some HMO prescription plans negotiate favorable rates for a brand name drugs and tend to push you towards using either the generic version or the lower cost drug. Healthier drugs plans allow you to order a 90 day supply instead of only 30 days, which is much easier for people taking daily medications.
4. Hospitals are the fourth factor to consider. Different coverage’s to take into account are outpatient surgery, emergency room coverage, and hospitalization. Also of concern are hospital coverage related to maternity, mental health or substance abuse.
5. The fifth feature you need to know is the plan benefits for well care services. Some plans provide a free annual physical (no copay). Benefits that can be beneficial to your health include cholesterol screening, immunizations and discounts on fitness programs. Smart HMO’s realize the best way to keep their expense down is to help you stay healthy.
Author of the article is the owner of Health Insurance California