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Health Plans

by: Dave Markel

Copyright 2005 Dave Markel

Choosing a health insurance plan that is best for you and your family is one of the most important decisions you'll ever make. Choosing between health plans is not as easy as it once was. Although there is no one best plan, there are some plans that will be better than others for you and your family's health needs. Plans differ, both in how much you have to pay and how easy it is to get the services you need. No plan will pay for all the costs associated with your medical care, some plans will cover more than others.

Most Americans have health insurance through their employers, and every year more employers offer insurance coverage by managed care organizations (MCOs). Today, Americans are in an era of managed care. It's a new experience for most people. Managed care companies may decide what doctor you will see and when, and what treatments will be covered. It requires you to make some important decisions because not all managed care plans are the same.

In choosing a health insurance plan, you have to decide what is most important to you. All plans have tradeoffs. It is worth asking yourself a few questions such as:

? How comprehensive do you want coverage of health care services to be? ? How do you feel about limits on your choice of doctors or hospitals? ? How do you feel about a primary care doctor referring you to specialists for additional care? ? How convenient does your care need to be? ? How important is the cost of services? ? How much are you willing to spend on health insurance premiums and other health care costs? ? How do you feel about keeping receipts and filing claims?

You might also want to think about whether the services that a health insurance plan offers meet your needs. Call the plan for details about coverage if you have questions. It is worth considering the following:

? Life changes you may be thinking about, such as starting a family or retiring. ? Chronic health conditions or disabilities that you or family members have. ? If you or anyone in your family will need care for the elderly. ? Care for family members who travel a lot, attend college, or spend time at two homes

Most health insurance plans provide basic medical coverage, but the details are what count. The best plan for someone else may not be the best plan for you. For each plan you are considering it pays off to find out about a range of things from physical examinations and health screenings, care by specialists and prescription drugs to vision care and dental services. It is also important to find out about the various offered services such as medical counseling as well as what is on offer.

Ask if a certain service is limited or not covered. You should find out if what is provided is what you require and if there are special programs for certain types of illness. It is also worth finding out about medicines and equipment that may be needed. Find out what types of care or services the plan will not pay for. These are usually called exclusions. Few indemnity and managed care plans cover treatments that are experimental. Ask how the plan decides what is or is not experimental. Find out what you can do if you disagree with a plan's decision on medical care or coverage.

Finally you should think about the location of services and how far you may be prepared to go for care. On this subject you should consider whether or not the plan handles care when you are away from home.

After you review what benefits are available and decide what is important to you, you can compare plans. Many things should be considered. These include services offered, choice of providers, location, and costs. The quality of care is also a factor to think about.

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