Choosing the Right Plan

How Do I Choose a Health Plan?

Picking a health insurance plan is a little like deciding on the right kind of car. Every model has different features, but what features make sense for you?

Likewise, when deciding what kind of health coverage is best for you and your family, it’s important to determine what your needs are before deciding on the type of plan you want.

Some plans protect you against major medical costs, but not the more routine services, like a checkup at the doctors. These plans are often less expensive than comprehensive plans, which protect you in the case of medical emergencies, routine visits, and they can even offer flu shots and value-added extras like reimbursement for gym memberships.

Balancing cost and coverage

Before choosing a plan, it may be useful for you to find out how you pay for care. How much are the copay, deductible, or coinsurance? What about the out-of-pocket maximum?

Some plans may charge a higher premium every month while offering lower copayments, deductibles, and coinsurance. Others that charge lower premiums may have you pay more out-of-pocket when you use your plan at a hospital or doctor’s office.

Often people make their decision based on predictability and affordability. A higher premium can be preferable for those looking for lower out-of-pocket costs, while those who don’t anticipate using services may choose a lower premium plan at the risk of higher out-of-pocket costs.

Whatever plan you decide on, it’s important to strike a balance between what you’re willing to pay and the level of coverage you are comfortable with.

What else to think about?

Another factor to consider is whether prescription drug, vision, and dental coverage are included with your plan. You may also want to see if a doctor or hospital that you’d like to use is considered in-network. (If they’re not, you may have to pay more when you visit them. It’s even possible that services received from the out-of-network hospital or doctor are not covered at all under the plan.)

If you are managing a chronic condition, you may want to take into account how often you’ll need to see specialists and identify which health care facility you’d prefer to use.

TOP