Choosing the Right Health Insurance Plan

When shopping around for the right health insurance plan there are many factors to consider. What type of coverage you need, who will be covered under the plan and how much you want to pay for the plan are just a couple things to consider. Doing a thorough health insurance comparison can save you money.

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According to an article on Oprah’s website even if an individual or family is covered by health insurance there are several companies that don’t cover everything. This leaves the insured to pay healthcare bills they hadn’t considered initially such as copayments on prescription drug fees or other out of network services.

Consumers Should Look For…

It’s important to know what you need for coverage before accepting a health insurance plan. Prior to your search you should ask yourself some questions. Such as how much health insurance coverage do I need for myself and my family?

For instance, those families with young children will make regular visits to their doctor for checkups and vaccinations. Knowing how much you can pay out of pocket for copayments and deductibles is important in these cases. Those who don’t expect to need medical care often during the year may opt for a lower premium insurance policy with higher copayments and deductibles.

Managed health care is popular among health insurance policies. Managed health care tends to be less expensive because medical center, doctors and hospitals will give insurance companies discounted rates for including them in their network of preferred professionals.

There are three types of health insurance options that fall under managed insurance. Health maintenance organizations, point of service plans, and preferred provider organizations. Each shares the common trait of having a network of professionals, but HMOs tend to not cover any costs when a professional outside of the network is used for medical care.

PPO health insurance and POS insurance plans have a little more leeway, but in most cases will not cover the entire cost when out of network care is used.

How Health Insurers Determine Your Rate

According to the National Association of Insurance Commissioners there are certain things health insurance underwriters look at to determine your premiums. They’ll require common information such as marital status, social security number, name, and address. They’ll also look at your health information and any health information of family members who are applying for the policy as well. The number of years for medical history can vary from insurance company so make sure you have all of that information while applying.

They will also ask if anyone has been denied health insurance in the past. However, some states do prohibit health insurance companies from asking this question. Once all required information is collected the underwriters will assess the individual and/or family members applying for coverage.

Once the application is accepted a rate class is assigned to each person in the family. Applicants are then assigned to a rate class which is simply a pool of customers with similar characteristics of risk. Once assigned to a class the premium rate will be charged to the customer and any yearly renewal premiums will be determined by the pool as a whole and any claims associated with it.

Most of the managed health insurance plans will require you have a physician that is in network as your primary care provider. For those who have a favorite doctor close to your home this can be an easy solution, however, if your provider is not in the insurance company’s network of preferred providers you’ll have to decide if you want to seek out a new physician.

Health Insurance Red Flags

Naturally you want to avoid scam health insurance companies. There are some telltale signs to look for. If you find that a company’s premium rate is much lower than their competitors you should be suspicious. Double check the policy to see if you’ll receive all the health care coverage you need.

It’s a good idea to check with your state’s insurance department and see if a company has been flagged for fraud. If you’re still hesitant there are several rating companies such as A.M. Best and the Better Business Bureau who assess insurance company’s customer service and financial outlook.

You can also look online for any customer complaints. The internet is always your friend when it comes to assessing a company’s reliability and customer service.

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