Health insurance is a very complicated field. Gone are the days when you made a nominal payment to the hometown general practitioner when care was needed. Today’s patient can see a wide array of specialists and therapists on the road to health improvement, and the resulting cost can be very high. Indeed, without health insurance, it may be insurmountable.
So most people go to great lengths to make sure they have health insurance coverage. They may have a means to buy it through an employer, union, or retirement system, or they may simply buy it directly from the source, much like they buy auto insurance.
Whatever your source, you will likely have a number of plans to choose from. Careful evaluation of these choices is critical to minimizing your costs and maximizing your coverage, so that when medical care is needed, you don’t have financial worries compounding your health worries.
Here are some of the things you should analyze before buying insurance.
Be Sure Specialized Care Is Covered
For most people, their most frequent interaction with their insurance plan is a routine trip to the doctor for a sore throat or other commonplace ailment. Consequently, when they are in the market for health insurance, they may focus too much on the plan’s coverage for that service and not enough on its coverage of other services.
There are a number of specialized types of care that some insurance plans cover. Everything from chiropractic care to dialysis could fall in their scope of services. When your circumstances clearly indicate certain things may be required–either now or at any time during your stint with the plan–you should investigate further.
Of course, not all treatment requires insurance, and there are ways to economize even with things like rehabilitation. But the more you can get from your insurance, the easier the rest of the process will be.
There is a misconception that having medical insurance prevents you from ever having excessive medical bills. However, the fact is that many people with insurance end up with medical debt, to the point of delinquency.
The reasons this happens are numerous. Sometimes, it’s simply a case of people who refuse to pay bills, thinking they’ll eventually disappear. Of course, sometimes they do–as a charge-off that impacts your credit score for years to come.
For others, it’s simply a matter of the excess cost. A hospital stay of three or four days can run into considerable out-of-pocket expenses because the patient’s deductible for the year hasn’t been met yet.
It’s very important to review deductibles, copays, and out-of-pocket costs when comparing plans without getting distracted by lower premiums. A careful financial analysis of what you could pay is very important to avoiding a financial crisis after a medical crisis.
Consult Your Map
Most plans have providers that are considered “in network” and others that are considered “out of network”. The pay rates for these two classifications differ; if you go out of network, you will be responsible for more of the cost.
Often, that’s not an issue; the patient can simply plan on going only to those facilities that are in network, and true emergencies are covered regardless of the facility.
But many American cities are situated near state lines, with municipal areas that cross the border. Many times the city on one side is smaller and may have fewer medical options, making it preferable to go to the other state. If this is your situation, you should be very careful in checking networks and their corresponding pay structures.
The purchase of health insurance is not only about covering costs, it’s also about peace of mind. Knowing that you do have some form of financial backing for needed care is very important in getting you or a loved one to the doctor, hospital, or other caregiver in a timely fashion. Choose your plan carefully to make sure it’s a good fit for your situation.