Monday, September 27, 2010

How to Evaluate Health Insurance Plans

 Whether you are looking for private health insurance plans or deciding between multiple corporately offered health insurance plans, the principles are the same. In order the compare health insurance, you need to get the research out of the way and know exactly what aspects are important to you and your situation. The following are the common comparisons which need to be made.

Deductable. The Deductable is one of the most important things to consider when comparing health insurance plans. The deductible is the annual amount that the health care provider will require you to pay for services before they begin to fund your claims. If you believe you are going to have high medical bills, it will be beneficial to get a low deductable, however if you never go to the doctor and are not planning on it, you may want to purchase "fire insurance" which has a high deductable. Just remember that if an accident happens, you will be liable for that deductable amount before any services will be paid by the insurance company.

Coinsurance is a term used for a portion of the medical bill which the insurance company is going to require you to pay. This still applies even after the deductable has been met. As an example, the insurance company may change a 45% coinsurance on outpatient services. That means that they are only willing to pay 55% of that themselves and you are responsible for the rest.

When you compare health insurance plans, make sure you look at the office visit costs. Often they vary depending on if you are seeing your primary care physician versus a specialist.

Prescriptions are important to the health insurance plans comparison. Some plans will only cover generic drugs. Some will cover both, but will cover a higher percentage of generics than name brands. If you are on medication currently, make sure that it is offered in generic form and that your doctor is willing to offer the generic before choosing a plan that does not cover name brand drugs.

Out of pocket limits are set on some policies as an absolute maximum per year or per lifetime that the insurance company will require you to pay. All copayments, deductibles and coinsurance payments should count toward this figure. Again, if you are young and healthy, it is unlikely that this is going to be an important element when you compare health insurance plans.

Healthcare savings accounts are becoming a common part of an insurance policy. These are accounts that you pay into in order to store up funds for deductibles and coinsurance payments or uncovered items. If you have need for this, ask about penalties and benefits for paying into these types of accounts so you can take these into account in your health care comparison.

If you have a pre-existing condition, then find out what coverage is offered as part of your health insurance plans comparison. Many times, the company will not cover any part of a condition which was diagnosed prior to the coverage start date.
Here are some other things to consider when you compare health insurance plans.
• Out of Network Coverage - Coverage for doctors or services which do not have a specific coverage agreement with the insurance company.
• Out of Country Coverage - This is usually only included for emergencies which happen outside the country of at all.
• Hospital Services - These are services rendered by hospital staff and typically fall under a different agreement than the standard coverage.
• Maternity Coverage - This can include any prenatal visits to specialists as well as the hospital services.
• Outpatient Services - X-ray and lab services or even outpatient surgery can be included in this section depending on the health insurance company.

Source:  here


  1. I like this, awaiting your next update!

  2. Bah, I gotta start looking into this, but I'm not looking forward to it. I was on my parents plan through college, but haven't been insured for like a year now... it sucks.

  3. What about "move to Canada"? That was my dental plan, anyway.

  4. So do you only cover insurance in the U.S., or...?
    Oh well, following and supporting.

  5. i wish i we could take private insurence in my country

  6. Interesting, I will look deeper in to this!