Choosing a medical insurance plan can be confusing, from deciding which deductible is the most beneficial to how to compare the benefits of the plans available. Whether paying for medical insurance out of pocket or being offered a plan through an employer, getting the most for the money helps give peace of mind. Several strategies can help make the best decision possible.
1. Compare Different Plan Types
There are several different types of plans and most differ by cost, whether needing referrals to see a doctor out of network and how to pay in case of a medical emergency. For example, when choosing a health maintenance organization over a preferred provider organization, there is a defined network of physicians to qualify for coverage.
In each plan, medical emergencies are handled depending on the individual provider. Choosing an HMO may result in lower costs when compared to a PPO. Taking the time to understand the differences between all available programs can be an important factor in long-term medical costs.
2. Consider Family Medical Needs
One of the most vital elements of choosing an affordable medical care plan is to consider your financial needs versus your family’s medical needs. Skimping on coverage to create savings may shortchange your children when they need a specialist or emergency medical care. Before you choose a plan, make a list of each family member’s needs and how often they need treatment for any chronic illnesses, such as type II diabetes or arthritis. Remember to figure in the cost of medications and which local pharmacies are covered by your provider.
3. Consider Emergency Medical Care
Urgent care centers and online registration for local emergency rooms have made long wait times at hospitals nearly obsolete; however, not all these services may be covered under every health plan. While it is impossible to know when a medical emergency will take place, understanding they type of coverage for an accident can give peace of mind when your spouse or children need immediate treatment. Review which urgent care facilities are in the provider network and which services may not be covered to be a prepared as possible for the future.
4. Look for Blanket Coverage
Depending on the type of employer-arranged medical coverage, medical and dental coverage may be available under the same plan. This can result in considerable savings when compared to a policy that requires separate payments for each, especially when needing to cover young children who will need dental care and checkups as they grow.
Massachusetts oral surgeon, Dr. George Hatzigiannis says policies that include dental coverage and access to oral surgeons help save on out-of-pocket expenses over plans that do not offer multiple coverage options.
Blanket coverage may also be helpful if you require specialized services for your family, such as mental health assistance or physical therapy. While you may pay a higher deductible for including these benefits, it may be less costly than going out of network if you choose a cheaper policy.
5. Calculate and Save
Some plans are similar, but differ in minor ways. To make an informed final choice use a simple twelve-month calculation for each. Multiply monthly premium payments by 12, then calculate each plan’s maximum out-of-pocket costs to discover which plan will cost you less in the long run. This calculation helps make the most informed decision to create a viable medical budget.
6. Review Upcoming Medical Needs
While the initial goal may be to keep monthly premiums low, be aware that lower cost programs may come with a higher deductible. This is probably not the best option if there are known upcoming medical costs. For example, anyone who needs surgery, is planning to have a child, is currently pregnant, or will need frequent treatment for a chronic illness, must balance low premiums against high deductibles. The more the policy pays for, the more money can be saved on frequent medical care in the near future.
Paying a higher monthly premium may be a better choice for large families. Growing children require immunizations, checkups, and other medical care that can add up if there are more than two children. Consult the employer’s medical insurance representative about how to adjust the deductible to get the best savings.
Buying medical insurance can be a challenge, especially with the options available (or lack of them) and fine print. Taking the time to calculate costs and savings versus the family’s medical needs can help make the most informed decision possible. Obamacare did not make things easier, and medical insurance plans are still hard to manage on family budgets.