Top 10 Health Insurance Considerations

Quality health insurance consistently ranks as the most desired employee benefit. According to the Harvard Business Review, 88 percent of employees ranked employee health insurance as a the top employee benefit consideration. Which makes sense considering that you can’t put a price on a clean bill of health.

Whether covered by an employer, or shopping for health insurance on your own, there are many considerations to have on your radar. No two policies are the same — there are degrees of coverage, varying price, various restrictions, and much more to keep in mind when seeking health insurance.

1. In-network doctors

One of the first things you will want to check is which doctors are in-network. Navigating the bureaucracy of health insurance networks can be frustrating, but it is an important part of saving money on care. If you have a doctor you like, or one that is conveniently near your home, you might want to check that they are in-network before settling on a health insurance policy.

2. Benefits

This is one of the most variable considerations to keep in mind. Each plan will offer different benefits, and with the right amount of legwork you can find one that best caters to your particular health needs. Do you need regular physical therapy? Do you have specific medication needs? Ask yourself these questions to guide your selection process.

3. Policy type

You’ll come to find out that not all health insurance policies deliver the same service — there are many different “types” of health insurance. The most popular types include HMO, PPO, EPO, and POS plans. These all have features that make them unique, but rather than get into the weeds listing all the benefits and drawbacks of each, we offer this simple advice: be sure to comparison shop. Look for a summary of benefits (which can be found on an online marketplace) and weigh your options from there.

4. Prescriptions

For many Americans, the cost of prescriptions is one of the most expensive, non-negotiable elements of health care. Americans paid an estimated $457 billion on prescriptions in 2015, which is comprises over 16 percent of all health care expenditures. And, considering over 60 percent of Americans take medications every day, this should be a primary concern when deciding on a health insurance plan.

5. I’m healthy so why bother?

Many young people choose to forgo health insurance all together, and endure the tax penalty, because they think they will never use it — this is ill-advised. For one, even healthy people require regular care, whether that means annual physicals, x-rays, etc. Plus, in the event of an emergency, you would be left fronting a costly, potentially six-figure bill which could drain your bank account and tank your credit scores. While the individual mandate was repealed in 2017, individuals are still legally required to have health insurance through 2019. But, legality aside, it’s best to pay for health insurance now to protect yourself from costly emergencies in the future.

6. Out-of-pocket expenses

The cost of health insurance is a balance between out-of-pocket costs vs premiums. Basically, low out-of-pocket with result in high premiums and vice versa. This is a good time to evaluate your overall health and determine whether you need a lot of medical services or not. For example, if you’re relatively healthy, it might be worth taking on a high deductible in order to benefit from low monthly premiums.

7. Support options

Let’s face it: the healthcare system is confusing. But, thankfully, many insurance plans offer a variety of customer support options to help bridge the knowledge gap for the everyday policyholder. Whether this is a 24/7 support line, or something more intuitive like telemedicine or a mobile app, be on the lookout for policies that offer the support features you need.

8. Chronic diseases

If you suffer from a chronic disease, your health insurance shopping process will be a little different. Usually people are willing to take on large deductibles in favor of low premiums, but if you expect many doctor visits in a year, you might want to approach your shopping a little differently. If you have any reason to visit the doctor often — whether that’s diabetes, cancer, or any number of maladies — search for the lowest deductible possible to keep your medical bills within reason.

9. Filling gaps

Despite how plans are advertised, there is no such thing as a comprehensive health insurance policy. Inevitably, there will be some gaps that might need to be filled. Whether you have many prescriptions, chiropractic care, massage therapy or any other, less common medical needs, you can expect to pay out-of-pocket or seek out a supplemental plan to cover costs.

10. Family coverage

Last, but certainly not least, one of the most important considerations when picking a health plan will be your family. All of the above considerations are at play, and compounded, with each family member. Plus, you will need to find a plan that accommodates all members of the family. When multiple family members factor into your health insurance decision it will be a balancing act, so plan accordingly.

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Image credit: iStock

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