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5 questions to ask before choosing a health plan

1. How often do you see your doctor?

If you use a lot of medical services in a year or if you use very little, you may want to consider a plan with a high deductible (the amount you have to pay before your insurance starts contributing) and a low premium (what you have to pay every month to have your plan).

In the first case, your medical expenses are likely to be higher than your annual limit (the max amount you have to pay for covered services in one year). Once you hit that, you won’t get any benefits from a higher premium.

In the second case you may want to risk a higher deductible since you’re not likely to spend a lot on health care.

2. What regular prescriptions do you use?

Be sure to check out your formulary. (How often does that phrase come up in conversation?) Untangling the terminology, a “formulary” is the system your insurance plan uses to decide how much they’ll pay for various prescriptions. If you’re considering a plan that doesn’t give you a good break on your meds – or doesn’t cover them all – it’s most likely not right for you.

3. Do you have must-see doctors, hospitals or providers?

Health care provider networks come in many varieties, including HMO, PPO and EPO. (Read this and save time for binge-watching HBO.) The main thing to ask is: will you have access to your current favorite doctors, specialists and hospitals in your plan? If so, it may be right for you … regardless of its limitations or the size of its network.

4. Do you want to pay less per month … or less overall?

If you pay a higher premium every month, you’ll usually get the benefit of a lower co-pay – the portion of payment you contribute to covered doctor’s visits and health services before the rest is paid by your insurance company after you meet your deductible. If you pay less per month, you may have a higher deductible … and higher upfront costs, depending on how many medical services you use.

5. How good are you at saving your money?

If you’ve saved up for medical expenses through a Health Savings Account (HSA), you may be able to afford a high deductible plan with a low premium. It will help pay for the covered expenses that your health plan doesn’t. You can set this up for yourself … or you may have an employer who will set it up for you. It’s tax deductible, you can receive contributions from anyone, and unspent funds carry over from year to year.

Need additional help navigating today’s uncertain health landscape? Call the friendly licensed agents at Mylo! We look forward to helping you out, even if you just want advice.

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