Are you Prepared to Shop For & Buy Health Insurance?
Helpful tips to ensure you make the best decision for you and your family
Written by: Andrew Hall.
Make sure your doctors (and any of your dependents’ doctors) are in-networkIn-network refers to the doctors, hospitals and other providers that are inside of your provider network. A provider network is a group of providers that have agreed with your health insurance company to treat its customers..
Closely look at how your plan works and which services require copaymentsA copayment is the fixed amount you pay directly to your provider for medical services or prescription drugs covered in your plan. For example: If your plan includes a copayment of $20 for office visits, you'll pay $20 to your doctor whenever you have an appointment., coinsuranceCoinsurance is the percentage of your medical costs that you pay after you meet your deductible. Your insurance company pays the remaining amount. For example: If you have a $1,000 medical bill and your coinsurance is 20%, you'll pay $200. Your insurance company will cover the final $800., or are subject to the deductibleA deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself..
Ask about dental and vision coverage before you purchase your plan.
Consider a High Deductible Health Plan (HDHP) that pairs with a Health Savings Account (HSA).
Buying individual health insurance can be daunting. Comparing deductibles and copays and monthly premiums can sometimes feel like you’re drowning in a sea of numbers. When you add provider networks and Health Savings Accounts (HSA) into consideration, the whole process can begin to feel a little overwhelming.
Before you make any health care insurance decisions, be sure to ask yourself these questions.
Is the Plan With the Lowest Premium is Best for My Health?
When working with a budget, some people are understandably tempted to go with the plan with the lowest monthly premium — but the premium alone isn’t the whole picture of what you’ll pay out of pocket for health care. The lowest premium will typically have a very high deductible, meaning you’ll pay more if you need to go to a doctor or hospital. Take into account your health care needs. If you regularly need medical care or take a regular prescription, paying more in monthly premiums to pay less when you utilize your plan may make more sense.
What Are Provider Networks and How Would They Affect Me?
Nothing’s worse than going to a doctor and finding out they don’t take your insurance. It’s important to confirm that your doctors participate in your plan’s network before you select a plan. Typically, your insurance carrier will have a section on their website that allows you to search for specific in-network providers. It’s also a good idea to double-check with your provider directly.
What Would be my Out-of-Pocket Costs?
It’s a good idea to have a deep understanding of your plan’s out-of-pocket costs, including copayments and coinsurance, before you see a doctor or go to the hospital. Understand where you are responsible for a copay or coinsurance and determine which services might require you to meet your deductible before your plan pays. Some plans also have separate pharmacy deductibles, meaning you have to pay a predetermined amount of money out-of-pocket before your plan starts covering your prescriptions.
Do I need Vision or Dental Coverage?
It’s a bad idea to assume a health plan also covers dental and vision. If you need this coverage, you will likely need to add a rider to your health insurance to get these “extra” benefits. Be sure to ask what dental and vision coverage (if any) is available to you on your health plan before you purchase it.
What is a Health Savings Account (HSA)?
If a plan has a high deductible, you can open an HSA to save money tax-free to pay for qualified medical expenses  – including individual health insurance premiums, copays, coinsurance, and more.
What Should I Ask my Doctor?
Health care should be a team sport. You know your body best, so it pays (and saves) to ask your doctor questions about which procedures and prescriptions are most necessary and to factor their responses into your policy selection.
Are My Dependents Covered?
Be careful to consider your family’s and dependents’ health care needs before choosing a plan. Whether it’s prescription drug coverage, specific providers, or dental / vision coverage — factoring in everyone’s needs on your plan helps avoid misunderstandings as your plan is used.
Should I work with a Licensed Insurance Agent?
Believe it or not, most people who shop for individual health insurance need help from a licensed insurance agent before they buy. Health insurance is a fairly complex product, so it makes sense to go over a few different options. GoHealth has licensed insurance agents that can discuss your options at zero cost to you.