Copyright 2005 Dave Markel
Choosing a health insurance plan that is best for you and your
family is one of the most important decisions you'll ever make.
Choosing between health plans is not as easy as it once was.
Although there is no one best plan, there are some plans that
will be better than others for you and your family's health
needs. Plans differ, both in how much you have to pay and how
easy it is to get the services you need. No plan will pay for
all the costs associated with your medical care, some plans will
cover more than others.
Most Americans have health insurance through their employers,
and every year more employers offer insurance coverage by
managed care organizations (MCOs). Today, Americans are in an
era of managed care. It's a new experience for most people.
Managed care companies may decide what doctor you will see and
when, and what treatments will be covered. It requires you to
make some important decisions because not all managed care plans
are the same.
In choosing a health insurance plan, you have to decide what is
most important to you. All plans have tradeoffs. It is worth
asking yourself a few questions such as:
* How comprehensive do you want coverage of health care services
to be? * How do you feel about limits on your choice of doctors
or hospitals? * How do you feel about a primary care doctor
referring you to specialists for additional care? * How
convenient does your care need to be? * How important is the
cost of services? * How much are you willing to spend on health
insurance premiums and other health care costs? * How do you
feel about keeping receipts and filing claims?
You might also want to think about whether the services that a
health insurance plan offers meet your needs. Call the plan for
details about coverage if you have questions. It is worth
considering the following:
* Life changes you may be thinking about, such as starting a
family or retiring. * Chronic health conditions or disabilities
that you or family members have. * If you or anyone in your
family will need care for the elderly. * Care for family members
who travel a lot, attend college, or spend time at two homes
Most health insurance plans provide basic medical coverage, but
the details are what count. The best plan for someone else may
not be the best plan for you. For each plan you are considering
it pays off to find out about a range of things from physical
examinations and health screenings, care by specialists and
prescription drugs to vision care and dental services. It is
also important to find out about the various offered services
such as medical counseling as well as what is on offer.
Ask if a certain service is limited or not covered. You should
find out if what is provided is what you require and if there
are special programs for certain types of illness. It is also
worth finding out about medicines and equipment that may be
needed. Find out what types of care or services the plan will
not pay for. These are usually called exclusions. Few indemnity
and managed care plans cover treatments that are experimental.
Ask how the plan decides what is or is not experimental. Find
out what you can do if you disagree with a plan's decision on
medical care or coverage.
Finally you should think about the location of services and how
far you may be prepared to go for care. On this subject you
should consider whether or not the plan handles care when you
are away from home.
After you review what benefits are available and decide what is
important to you, you can compare plans. Many things should be
considered. These include services offered, choice of providers,
location, and costs. The quality of care is also a factor to
think about.
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