Tips For Buying Health Insurance
Did you recently lost your job and found COBRA health insurance premiums way too expensive
? Or you dont have health insurance because your employer does not offer it?If you live in USA, you know that costs of health care and medications have been going up every year. It could be hard to afford those high health insurance premiums but it could be even more dangerous if you dont have any coverage. With the average night in a hospital reaching almost $8K average, its a good idea to carry at least a basic insurance plan.
Its a good idea to look into the individual market to buy some health insurance. You will find many affordable high deductible health plans. Here are few things to keep in mind when shopping for health insurance.
HMO OR PPO: You will have to pick a particular doctor with a HMO plan. If you have to go to specialist your Primary Care Physician (PCP) must refer you. This could take few days some time. A PPO plan provides you a list of doctors and specialist in a particular network. You can go directly to that provider in the list. You are not stuck with a particular PCP in a PPO plan.
Expected Needs for Health Care: Estimate the services you will need for the whole year. If you have children, you may need plans with unlimited office visits. How often do you go to Doctors? Does anyone take any brand name medications etc?
Affordability: Usually HMO plans have better coverage and low out of pocket expenses but on the other hand the premiums are very high. If you're in your 20s or 30s, have no children and some extra savings, you can save money by buying a policy that covers only catastrophic illnesses. These plans usually have high deductible. e.g. in Fremont, CA a male age 25 can get a $1500 deductible plan for approx $85 per month.
Office Visits, Prescriptions, Lab and X-ray: These services are the most important services that most people will use. Review the coverage of any health plan to determine if your current prescriptions are covered and at what level. X-rays are a routine part of some treatments, so it's wise to make sure X-rays are covered in each plan you consider. Recently, we have seen plans with limits on office visits. e.g. 4 visits at $30 copay for whole year. Labs and X-rays are usually subject to deductible in the individual plans.
Annual Physical/Preventive Care: Health Care Reform requires all health plans to offer preventive care i.e. annual physical and tests related to it at no cost to the member. Please look and make sure your plan covers annual physical. Its highly recommended to go see a doctor at least once a year for check up.
Emergency Services : Make sure that you understand whether or not vosts including co-pays or co-insurance, or services such as hospital and surgery care, apply towards the deductible.
Annual Out of Pocket Max: This is the amount that will be the worst case scenario if there is a huge bill. A member will not pay more than this amount in a calendar year. Usually this amount ranges between $3K to $7K for most individual plans.
Maternity Coverage: Some individual plans are sold without any maternity coverage. If you are male and seeking coverage just for yourself. You definitely should look for plans that dont offer maternity coverage and save money. On the other hand any female planning a family must make sure that this coverage is included in your health plans.
If you have any questions, please call Sunny Sethi @ 408-986-8506
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