What Factors Should You Consider When Buying Health Insurance?

April 28, 2022

Even though everyone needs health insurance, no two people have the same healthcare needs. People who are in good health don’t need to visit the doctor as much as those with chronic conditions. Seniors particularly have healthcare needs that don’t necessarily apply to young people.

So here’s a look at what you need to think about when shopping for healthcare insurance.

How Much Coverage Do You Need?

When you shop for a health insurance policy, one of your top concerns should be the amount of coverage you need. Different policies provide different levels of coverage, as each insurance company is unique and designs its own plans. The more you need to see a doctor regularly, the more coverage you need.

The four-tier levels of health insurance plans are Bronze, Silver, Gold, and Platinum. Each tier differs in the percentage of costs the insurance company pays. With a Bronze plan, you’ll have lower monthly premiums but a higher deductible than a Platinum plan.

You can consider buying a family plan to reduce your overall costs. Remember that health insurance plans are typically updated every year, so consider the new changes when buying one for yourself.

What Type of Health Plan Works for You?

There are various health insurance plans to choose from, such as an HMO, EPO, and PPO. Here is what these plans offer:

  • Health Maintenance Organization (HMO) 

    This plan requires you to visit a specific healthcare provider and a primary care physician (PCP) to refer you to a specialist, except in emergency cases.

  • Exclusive Provider Organization (EPO) 

    You are not required to have a referral from your PCP to see a specialist under this plan. However, the providers you choose must be contracted within a specific network.

  • Preferred Provider Organization (PPO) 

    For maximum flexibility, this plan allows you to see both PCPs within a network and outside the network for an additional cost.

Health Insurance Provider Network

Ask yourself if you want to see the physician of your choice. Find out their network affiliation and check whether they are in-network healthcare providers. If you don’t have a specific physician in mind, start checking healthcare directories that provide network information. Larger networks provide a wide range of choices for hospitals.

Key Health Benefits

Be aware that health benefits and costs vary among different providers and locations. The most important health benefits include emergency care and hospitalization, along with preventative and wellness services. Regular care coverage typically involves prescription drugs. If you take a specific medicine, review your plan’s prescription drug coverage (also known as “formulary”) to check whether it is covered.

Adding up Total Costs

Use online shop and compare tools to evaluate different healthcare plans. The total healthcare costs you will pay out of pocket will be based on numerous factors, such as your current health condition, age, income, and household size. Review each plan’s monthly premiums and coverage options and also consider the total healthcare costs you will be paying annually.

Buying the right healthcare plan is a complex task because of the wide range of insurance coverage choices available. Remember that you’ll need to customize your plan according to your personal needs to ensure extensive coverage at all times. Contact our experts at Gant Insurance Agency to get the right health insurance coverage today.