Healthcare in the United States is expensive. Health insurance offers a way to bring down the cost to a reasonable amount. There are several types of health insurance plans available, and each has different rules and arrangements regarding the care the insured person receives. Before you buy or change your health insurance, you should work out the answers to these questions.
Where Will You Receive Care?
Insurance companies often contact a set network of healthcare providers that have agreed to offer services to those enrolled in certain plans at reasonable rates. If the provider isn’t part of their network, the insurance company may not pay at all or may only cover a smaller portion than usual. So always check the network and locations where care is offered.
What Is Covered?
The Affordable Care Act has introduced more standardization to insurance plans. Now plans cover essential health benefits like emergency services, hospitalization, laboratory tests, maternity and newborn care, mental health, substance abuse treatment, outpatient care, pediatric services including dental, prescription drugs, preventive services, chronic disease management, and rehabilitation services.
How Much Will It Cost?
This is a little complicated. The upfront cost, or premium, is the most transparent part of the costs. But there is usually a cost to access care. This is counted with deductibles, coinsurance, and copays and is what you will pay from your pocket when you receive care. Take the time to look up all the terms mentioned and understand what they mean. The typical rule is that the more you pay as the premium, the less you will pay when you access care and vice versa. But either way, you will spend some amount. Ideally, you should choose a higher premium to minimize the costs you have to pay when you need care so that you don’t need to think twice about getting the help you need. You should also study the ‘covered benefits’. These refer to the health services included under the health insurance plan you pay for. If it is covered, then some portion of the cost for this service will be paid for by the insurance company. Also, remember to always have the ‘deductible’ amount on hand in case you need health care.
