Need Health Insurance? Here’s How To Pick The Right Plan

Young man picks a health insurance plan online

When it comes to your health, you want to pick the best possible health insurance plan. But how do you decide which parts of a plan are most important? How can you be sure that your policy will cover your medical needs? In short, how do you find a plan that works for you?

It’s easier than you think! Here’s a simple, six-step guide to finding the right health insurance for you and your family.

1) Pinpoint What You Need

First, decide which medical services you need covered, which services you want covered, and which services you can go without.

Here are some examples of situations to consider before you shop for insurance:

  • You’re in good health and rarely see a doctor: Look for a basic plan that covers you in case of emergency. You’ll have higher out-of-pocket costs for medical services that you actually receive, but you’ll pay much less in monthly premiums.
  • You have a chronic condition: Find a plan that helps pay for specialist visits, prescription drugs, screenings, lab tests, counseling, or therapy that help you manage your condition.
  • You’re pregnant: All ACA-compliant plans must cover maternity care and childbirth, but you’ll still have to pay for related hospital costs. Search for a plan that pays a higher portion of your out-of-pocket expenses.
  • You’re expecting a hospital stay: Are you planning to undergo a major surgery or seek extra treatment for a medical condition? Pick a plan that covers the types of doctors, prescription medications, and specialized care that you’ll need for this event.
  • You have dependents: If your spouse or children have any medical concerns, make sure the health services and medications they need are covered by your plan.

2) Remove What You Don’t Like

Think about your past or current health insurance plan. Were there any parts of your plan that you didn’t like? Maybe you paid a high premium for covered services that you never used. Maybe you were surprised by a costly medical bill or unexpected out-of-pocket costs. Maybe you didn’t like your doctor or your insurance company. Make a list of issues you’ve had with past insurance coverage, and look for plans that address those issues.

3) Pick A Doctor

Want to keep your doctor? Make sure they accept your new plan. If you see a doctor who isn’t included in your plan’s network, depending on what type of plan you are on you may pay 100% of the bill or receive a lower benefit level for going out-of-network. You might also have to pay for certain services (such as physicals, vaccinations, and counseling) that would otherwise be covered by an in-network healthcare provider.

First, make a list of the healthcare providers that you want to continue seeing. Then check each plan’s provider directory to figure out which networks those doctors or healthcare facilities are part of. (You can also call your doctor to find out which plans they accept.) If any plans don’t include your doctor’s network, cross them off your list. You don’t have to lose your doctor just because you switch to a new plan!

4) Get Your Medications Covered

The same goes for prescription drug coverage. All Obamacare-compliant plans include prescription drug coverage as a benefit, but plans vary in how much they contribute toward certain medications. Make a list of the prescription drugs you need, and look at each plan’s formulary to find out if they’re included. If you need multiple medications, find a plan that has the most generous coverage for your specific prescriptions.

5) Pick A Plan Type

When you search for a health plan, you’ll probably choose between an HMO or PPO plan. An HMO is typically the cheapest option because you seek care from a limited network of providers. A PPO typically has higher premiums because you have greater freedom in choosing which doctors and medical facilities you visit.

To learn which health benefits are covered by a health insurance plan, check the Summary of Benefits and Coverage. This standardized form is required by law for each health plan so that you can more easily compare their coverage limits and out-of-pocket costs.

6) Ask An Expert

Want to be sure you picked the right plan? Talk to a licensed health insurance agent at Regency West Insurance Services. Our insurance experts will work with you one-on-one to answer your questions, pinpoint your coverage needs, and help you pick a plan. Plus, their help is free! (Their commission is already added to/included in your premium.)

Just call (858) 699-0286 or fill out a contact form online. Either way, you’ll be put in touch with an agent who will find a plan that suits your health needs and budget.

Not all plans offer the same coverage, and no two individuals have the same health needs. Instead of searching for the best plan out there, pick the best plan for you — it could save you thousands in healthcare costs. Use Your Health Insurance Advocates, and find the right plan today!