The Importance of Choosing the Right Plan

When selecting a plan, you will want to closely review and compare both the basic benefits offered as well as any additional covered benefits for each of your options. Comparing benefits to the financial portion you would be responsible to pay will help you understand the best value. Sometimes the cheapest monthly plan may ultimately mean you are paying significantly more during the year for your care.

Try to consider factors beyond simply the amount of the premium. You will want to look at both your monthly cost along with the likely cost when receiving medical care to ensure your family budget can handle both. Out-of-pocket costs tend to impact a family’s budget all at once rather than as a reoccurring budgeted monthly bill like premiums.

It is wise to be familiar with the cost sharing amounts associated with medical services which you anticipate yourself needing most often such as: routine care, specialty care (such as the care you may need for a chronic illness such as cancer), emergency care, and prescription drug costs.

In addition to these cost factors, you will also want to consider whether your doctor is an in-network provider (these doctors and hospitals have an agreement with the insurance company to provide care at a reduced rate). You will also identify if the medicines you need today are included in the plan’s formulary i.e. the list of drugs which may or may not be included in the prescription drug plan. There are also medical services which are not eligible to be paid by your insurance plan, these are known as Exclusions and if you choose to receive these services you are required to pay all of the costs, without any cost sharing by the insurance company.

Every health insurance plan must include a Summary of Benefits and Coverage that outlines your plan in easy to understand language.

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