Each year from late November through early January of the following year, U.S. citizens can enroll in a health insurance plan of their choice if they do not receive a health insurance policy from their employer. If your employer provides health coverage, you can skip shopping for a health policy, but if their policy does not cover everything you need, then you can legally purchase another health insurance policy. Because the healthcare marketplace offers a vast number of options, this article offers actionable advice on choosing your health insurance plan.
Consider your Health Needs
Before you shop in the healthcare marketplace, make a list of your medical needs. Include annual items, such as eye exams and dental visits. If you receive a diagnosis of a chronic condition, consider how many doctor visits you should have each year to properly manage it, not how many you can currently afford. Any plan that you choose should provide coverage for all of these appointments.
Know the Lingo
The insurance industry loves its lingo. Your premium refers to the small amount of money you pay each month to own the insurance policy. It may not seem small when you compare insurance prices, but it’s tiny compared to a deductible, the money you must pay for healthcare before insurance pays for anything. A policy with a deductible of $6,000 means that you must pay $6,000 in healthcare bills during the year before insurance pays for anything.
A policy may have a dialed-up premium or deductible. Dialed-up refers to more expensive. A higher deductible makes the monthly premiums cheaper. A more expensive premium typically comes with a lower deductible. If you have few health issues, a high deductible can save you money, but those with chronic disorders should consider choosing the higher premium, so the costs remain predictable, and the policy covers medical needs fully.
Don’t Choose the Cheapest Option Based on Price Alone
Every person should visit their primary care physician at least once per year. Every healthcare plan in the marketplace covers that because the government requires them to do so. If a policy only covers minimum visits, although it probably costs very little, it won’t help you maintain your health. Instead of choosing an insurance policy based on its cost, eliminate the plans that do not cover wellness and common tests, and choose from those that remain.
Consider Copays and Upfront Costs
A policy’s copay, the amount you pay when you visit the doctor, varies by policy. Some copays of $15 exist, while others range in the $100 area. Carefully consider copays, noting that you must pay them at the doctor’s office before you can see your physician. Copays contribute to your annual deductible.
Upfront costs refer to the policy set-up fees, deposits, new customer fees, etc. An insurance company may require an individual to pre-pay more than one month of premiums. On the healthcare marketplace website, each insurance company provides detailed documentation of its policy fees and costs. If you shop for private health insurance outside of the marketplace, carefully examine all of the available information because private websites do not provide the same detailed information, so you must ask for it.
Compare Dental and Orthodontic Options
When you compare dental plans, consider your family members’ dental needs, too. When purchasing coverage in the healthcare marketplace, you can typically purchase a plan that covers your nuclear family. Since children may need braces, examine orthodontic coverage because adults comprise only one in three orthodontic patients.
Every family member needs to visit the dentist at least twice per year, but 60% of adults aged 20 to 64 visited the dentist in the past year. Ensure that any plan you pick covers annual visits to the dentist; ideally, the policy should provide a visit every six months. Few, if any, policies fully cover teeth realignment, better known as braces or Invisalign, but most cover a percentage of it, usually in the range of 25% to 30%.
Consider Health Insurance an Investment in Your Wellbeing
Think of the monthly premiums and deductibles you pay as a way to invest in your health. For most people, buying a health insurance policy makes medical care more affordable. Research your policy options and choose a plan that provides wellness care and annual primary care visits.