Types of Health Insurance Plans: What to Look for When Weighing Your Coverage Options

The uninsured population is growing, up from 44 million just a year ago, partially because the system is so complicated. If you don’t understand the types of health insurance plans available, you could be overwhelmed with choices, terminology, and options new to you. Taking the time to look at the range of plans in advance can save you money and ensure you have care that you deserve.

Here are four things to look for in high-quality care.

1. Premiums Matter

While for most people “insurance is insurance” and you either have it or you don’t, you could be paying a lot more for the same coverage as your neighbor. Your premium s the bill that you pay every month to have insurance coverage. With the help of the Affordable Care Act, many people get subsidies to help them pay their premiums.

While it’s unlikely, you could be paying more for insurance but have a worse policy than someone who is paying less every month. If you haven’t applied for a subsidy, you should check and see if you qualify. Premium credits can help you to pay for better insurance than you may be able to afford on your budget.

While it’s not true with every type of product, health insurance is one of the few things where you truly get what you pay for. If you’re paying for the cheapest health insurance that you can get, you could be saving money with your premium. However, the lowest price isn’t always the best deal.

Because you’ll be required to pay other fees, co-pays, and for anything under your deductible, you could spend more on a cheap plan.

2. Consider Deductibles

If you haven’t thought much about the deductibles in potential health care plans, you need to think more about it. While you might think of your sticker price as what is most important to your budget, deductibles belie the real cost of health care.

While you might be paying just $100 a month on your insurance, when it comes time to get treatment, you could be tearing a hole in your budget. That’s because your deductible measures the minimum rate of coverage. When you have a high deductible, that means nothing below that amount will be covered by your insurance.

Think about your deductible as a bar that costs need to leap over before your insurance will kick in. If you have a $5,000 deductible, you could pay $4,999 dollars for treatment, on top of your premium, before your insurance kicks in.

Paying a slightly higher premium will lower your deductible. Additionally, you’ll find more of your most basic preventative care treatments will be taken care of.

If your premium is too high to handle and you keep yourself in very good shape, you might want to just have a “catastrophic insurance” plan. This will kick in if something serious happens that costs more than a few thousand dollars to cover.

3. Look At The Network

If you already have a set of doctors and specialists that you know and love, you might want to keep them with your new insurance plan. However, if you’re looking for a low premium and your doctors don’t accept that low-premium insurance, you might have to seek new doctors. The alternative is that you could be paying for care out of pocket, spending more for cheaper insurance.

Most insurance companies have a strong online presence now and will allow you to search for doctors in their network. The bigger their network is, the easier it will be to find care for your issues. When a doctor accepts a certain type of insurance, they’re added to that network.

If you want to have your treatment covered, you’re going to have to stick strictly to your network. This can be a challenge if you have insurance from another state. It can also be hard on doctors as the more varied the types of insurance they acce3pt, the more legwork they have to do.

If you find that you’re being asked to drive 50 miles out of the way to see your doctor, look for another insurance plan. Check out the network that HealthEdge offers for an example of what a network can look like.

4. Look At What Happens Out of Network

If you find that you might need a lot of out of network care, you should seek a flexible plan. If you’re getting insurance through your employer, you’ll get a better deal than paying for an individual plan. Their HR department has someone who can help you figure out everything you need to know to get the care you seek.

If you suspect you’ll have a hereditary issue that could require seeing a lot of specialists as you age, you should seek insurance with a flexible plan. Otherwise, you’ll be footing 100% of every bill that you get. If you see two plans that look quite comparable, you might find that one offers out of network care while the other doesn’t.

Some plans won’t give you anything for out-of-network coverage, even in an emergency situation. While you may think you could simply avoid going outside your network, that’s hard to predict. Going on vacation, traveling for a work trip, or getting a complicated treatment could put you out of network.

If you get surgery from a set of doctors and at a hospital all in your network, your anesthesiologist could be out of network. You’ll get a surprise bill, even if you think you covered all of your bases.

Types of Health Insurance Plans Can Vary

If you’re struggling on deciding between types of health insurance plans, you should make a limit of what your bottom line is. Decide what the maximum that you’ll pay and start your search there. Look for value rather than price and you’ll be able to find the perfect plan.

If you want to take care of yourself outside of working with doctors and health specialists, check out our guide to self-care.