You don’t have to be a pro to make a decision about your health plan. But when you buy your own plan, for yourself or your family, it can get a little bit complicated. That’s why we asked an expert to help with tips to make the right decision for you.
Casey Meehan of GHB Insurance in Olympia, Washington, works with people to help them understand their options when picking a plan. Here are his tips:
- Talk to your doctors to make sure they are in-network with any of the plans you are considering.
- Identify the deductible and what services are not subject to the deductible. Plans that offer first dollar benefits for services such as office visits, prescription drugs, lab, x-ray, or urgent care can often be more cost effective than plans with a lower deductibles that offer little pre-deductible cost sharing.
- If you have high expected health costs for the upcoming year, consider a gold option for overall savings. Conversely, if you normally have low expected health costs year-after-year, consider a bronze option for overall savings.
- Visit the carrier’s website and access their prescription drug list (formulary) to calculate your prescription costs.
- Consider why some carriers and plans have significant differences in premium. There’s been a trend the last few years where plans that have larger networks and the freedom to choose your provider are often more expensive; lower priced options often are associated with much more narrow or restricted provider networks.
- Evaluate and understand the out-of-pocket maximums and how they apply to you.
- Know which insurance plans cover the hospitals, urgent care clinics, and immediate care facilities where you live, work, and play.
- Determine if you may have any out-of-state medical needs this upcoming year and whether your plan includes a telemedicine benefit.
- Pay your first premium at time of application or as soon as receive your first bill so you can activate your coverage and don’t experience a delay in being able to use your benefits.
- Partner with a broker that offers free assistance with troubleshooting application issues, claims advocacy, billing resolution, household updates, and making plan recommendations. Check our list of Enrollment Centers to find a broker in your area and make an appointment for in-person assistance.