Health insurance companies offer multiple types of benefit designs, which affect where you can get care, how much you’ll pay and whether you need a referral to see a specialist.
EXPERT TIPS
How to Choose the Best Health Insurance for You
Mark Fendrick
Advisory Board Member
Les Masterson
Insurance Editor
Ashlee Valentine
Insurance Editor
Amy Danise
Insurance Managing Editor
Michelle Megna
Insurance Lead Editor
Look Beyond the Premium
A low premium may be attractive, but other factors should be considered when choosing a health plan, such as ensuring your trusted clinicians are included in the plan’s network and calculating all of the costs. I’ve found that those who have predictable clinical needs may pay less out of pocket if they enroll in a plan with a higher premium but more generous coverage for needed care.
Make Sure Your Doctors Are In-Network
I suggest calling your doctor’s office directly to ask if they are in your health plan’s network—don’t assume the insurer’s provider directory online is always up-to-date. Paying the in-network rate will help save you significantly.
Insurance Editor
Go on a Spouse of Parent’s Plan
If you’re eligible for a health plan through your job or a spouse or parent’s job, I’ve found that’s often the cheapest way to get the best health insurance.
Insurance Editor
Find Out About Your Prescriptions
If you have prescriptions, I would check with the insurance company to confirm that they’re covered and see how much you would have to pay out of pocket. You don’t want to discover later that you have huge out-of-pocket payments for prescriptions that aren’t covered.
Insurance Managing Editor
Figure Out The Type of Plan That You Want
A health plan’s benefit design plays an important role in terms of a plan’s flexibility. For instance, an HMO typically costs less than a PPO but an HMO comes with primary care referrals to see specialists and you generally must stay within the plan’s network. I suggest considering those factors when deciding on a plan.
Insurance Lead Editor
