understanding your medical insurance policy

Things To Know Before Selecting Medical Coverage

by Peppi Halko

If it's time for you to select a new medical insurance plan, you have a number of things to think about. Medical insurance plans can come with a lot of fine print, so it's important that you understand what you are getting before you sign up. Here's what you need to know to make sure you fully understand your insurance and select the plan that is best for you.

Make Sure You Can Afford Both the Premium and the Deductible

When it comes time to select a plan, a lot of people focus on the premium since that is the price they must pay every month for coverage regardless of whether or not they use the plan. Selecting a lower premium sounds great because it means there will more money in your pocket every month if you have no incidents or illnesses. But you should also pay close attention to the deductible amount. Normally, a plan with a lower premium has a higher deductible. If you end up with a low premium but a very high deductible, there's a chance you may not be able to afford your health care bills when they come in because the deductible you have to pay before coverage kicks in is too high.

Pay Attention to the Network

Different plans organize their coverage in different ways. Some plans may only allow you to get coverage from a certain network of doctors or hospitals. Others may allow you to go out of network, but the deductible or fee will be higher. Go down the list of your current doctors or health care providers and figure out if they are in or out of the network offered by your medical insurance provider. If your current doctor isn't part of the network but you really like the sound of a specific plan, the insurance company may be able to recommend another in-network doctor who is just as qualified as your current one.

Keep Reading if You Have Special Issues

Most medical plan documentation tells you what the premium and the deductible is off the bat and then follows that up by discussing things like general doctor visits or how much you will be charged at the pharmacy. But if you have specific health issues you know may come up in the next year, you need to keep reading. Health situations like a major surgery, pregnancy, or treatment for a serious illness may have their own terms and stipulations that are different or fall outside the terms of the deductible. If you don't see your specific situation, reach out to a medical plan provider for more information.