The truth is that choosing the correct health insurance plan can save you thousands of dollars over the course of the following year, but more significantly, it will provide you with peace of mind in the event that life unexpectedly changes your plans.
This manual explains everything in simple terms. No technical terms. Do not use scare tactics. Just how to choose a plan that truly works for you, what to look for, and what to avoid.
Step 1: Recognize When You Can Enroll
First things first: Avoid dozing off on the due date. You can enroll in or modify your health insurance during open enrollment, which occurs once a year, generally in the fall. If you miss it, you can be left with a plan you detest or none at all.
Pro Tip: Put a reminder in your calendar. Twice.
Step 2: Get the lingo down to the basics
The terms you truly need to know are listed in this cheat sheet:
Premium: The amount you always pay each month.
The amount you must pay out of pocket before your plan begins to assist is known as the deductible.
A copay is a set amount you pay for particular services, such as $30 for a visit to the doctor.
Coinsurance is the amount you pay once your deductible is met (20% of a hospital bill, for example).
Step 3: Consider Your Actual Life
Consider this:
How frequently do you visit the physician?
Do you regularly take prescription drugs?
Are there any upcoming major operations, births, or procedures?
Are the doctors you prefer in-network?
What you think will occur—perfect health, no medical visits—is not the point of this. It is important to be truthful about the type of year you anticipate.
As a general rule, a high-deductible plan with cheaper premiums can be a good fit if you do not take prescription drugs on a regular basis and do not visit the doctor very often. A plan with a higher premium but lower out-of-pocket expenses can end up saving you more money if your demands are constant.
Step 4: Verify the Network—Yes, networks of providers are included with Real Health plans. While some plans (like PPOs) provide you greater freedom, others (like HMOs) exclusively cover care that is provided inside the network.
Do not presume that your physician is covered. Even if you continue to use the same insurer, make sure to check annually. Unexpected out-of-network bills are the worst form of mail because networks change.
Step 5: Examine Coverage for Prescription Drugs
Check your formulary (fancy phrase for the plan’s medicine list) if you use any medications, whether it is a regular asthma inhaler or anything more specialized.
Is your prescription drug covered?
What is the price under this plan?
Are generic alternatives available?
High prescription expenditures can catch you off guard, even if everything else appears to be in order.
Step 6: Take into account an FSA or HSA
You may be eligible for a Health Savings Account (HSA) if you select a high-deductible health plan (HDHP). This enables you to set aside pre-tax money for medical bills, and the funds are carried over from year to year.
Some plans also allow you to set aside money for health expenses tax-free through Flexible Spending Accounts (FSAs), which you can use or forfeit by the end of the year.
Step 7: Do not Just Use the Plan from Last Year
Perhaps it was successful last year. Or perhaps you did not utilize it much. However, networks, coverage, and prices vary annually. Unexpected coverage gaps or increased costs could result from auto-renewing without checking.
As you would with your personal health, give your plan a brief yearly check-up.
Step 8: Seek Assistance If You are Stuck
Ask HR if your employer provides perks. Ask a licensed agent or navigator for assistance if you are purchasing on the marketplace. Asking questions is perfectly OK because this information is confusing and there is support available.
Conclusion: Order Over Chaos
Solving a riddle in a confined escape room should not be the experience of purchasing health insurance. You can make an informed decision that truly fits your life and possibly saves you money if you do a little planning beforehand.Breathe deeply. You are capable.
