Health Insurance Blog

Jump Into An Awesome Policy

Posted by:
Tim Jackson
November 10, 2016
Health Insurance has many options. A lot of these plans are less than awesome. But we can help you find the plan that is awesome for you.

Health Insurance has many options.  A lot of these plans are less than awesome.  But we can help you find the plan that is awesome for you.

There are lots of things to consider when picking a plan.

How often do you go to the doctor?

If you go to the doctor often, you may want to pick a plan that has low co-pays.  If you rarely go to the doctor, you may want to consider an HSA plan.  Your premium will be lower, and the cost that you do accumulate will be low because you are not visiting the doctor.

Are you on prescription medication?

Some plans have better prescription coverage than others.  If you are on medication that you take regularly, it may be worthwhile to have better prescription coverage than just a generic plan.

Do you go to the doctor more for preventative care or medical treatment?

Preventative care is covered 100% by all “Obamacare” health insurance plans.  You are able to have those included.  If most of your visits are well child checks, then you don’t need to be paying for a high premium and benefit plan.  However if you go to the doctor for regular treatments, then you are going to want a plan that covers as much of those costs as possible.

Do you usually meet your deductible during the year?

Some people do.  Some people don’t.  It has to do with a couple of things.  What is your deductible?  Is it so crazy expensive that you are happy that you never have health care costs to match and exceed that number? Or do you go to the doctor enough between all the members of your family to the point that it’s part of life to hit the deductible at some point during the year?  The good news about deductibles is that once you do meet them, you usually get a lot more coverage for your additional costs.  So if you are paying $6,000 a year in medical bills but you have a $10,000 deductible then your insurance isn’t going to help you out very much.  But if you have $6,000 a year in medical bills and you only have a $3,000 deductible, you will get that price break much sooner.  However, you typically pay more out of pocket per month to your premium for a low deductible plan.  So you need to run all those numbers and figure out what is cost effective for your situation.

Do you usually meet your out of pocket max?  Do you come close?

I know a couple that almost always hit their out of pocket max.  They go to the doctor that much.  The awesome part is that an out of pocket max is exactly that.  Once you hit that number–whatever it is–you don’t have to pay a penny more for health care that year.  So if you need to get more medication, it’s free.  If you need to go to the doctor, no more co-pays or bills attached.  You live the high life as far as benefits, and if you’ve paid enough to hit the out of pocket max, chances are you deserve to have those last few appointments taken care of.

Are your premiums in your budget?  Can you make them fit in your budget?

Frankly, for a lot of people, premiums are not in their budget.  Especially when those premiums are significantly high.  The money has to come from somewhere, so you may look into shopping sales and saying “no” to more of those non essential purchases.  Share an entree if you are going out to eat, or eat at a place that is less expensive.  Save those splurges for special occasions.  Eat cheaper meals at home.  Avoid buying things that you don’t actually need.  I know, a nice dinner out is much more fun than paying for health insurance, but the money has to come from somewhere.  If you are doing all these things and you are still struggling to make your premium payments, then you need to evaluate what plan you are on and if that is truly a necessity or not.

Are you paying a lot out of pocket in addition to your premium?

Unfortunately, some plans are just nasty to the person who has the plan.  If you pick the wrong plan for your situation this will most certainly happen.  Maybe you are paying $500 a month on your premium, but your plan covers very little.  So since you need to go to the doctor a lot because of your needs, you are also paying huge co-pays or even receiving hundreds of dollars worth of medical expenses.  This makes you pay out on both ends.  No bueno.  So if this is happening to you…please look into some other options.  Yes, health insurance is expensive.  Yes, medical care is expensive.  But if you are paying hundreds upon hundreds of dollars in a month, chances are you can find a better plan for you.  Not always, but it’s at least worth looking into.

So no matter what you do, go into picking your health insurance plan with all the facts.  Talk to an agent that can answer your questions.  Research these topics on your own.  Do something.  Because this is a lot of money, and you need to know that you are spending it in the way that benefits you the most.  Pun intended.

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