Things You Need to Know When Buying Health Insurance

There are a lot of factors to keep in mind when you begin hunting for the right health insurance plan. The monthly cost is usually the primary focus for most people when selecting health insurance. However, it is important to make a compare-and-contrast checklist between insurances to ensure you get the most bang for your buck. In this article, we will go over these factors:

  1. What is a Premium?
  2. What are Deductibles?
  3. Co-pay and Co-insurance
  4. Pharmaceutical Coverage
  5. Dental Benefits


1. What is a Premium?

Premium is the total cost you pay for a health insurance plan.  Different plans have different payment options: monthly fee or in full. This amount is different from the deductible. All in all, the “premium cost” depends on the benefits you will be receiving.

2. What are Deductibles?

A deductible is a set dollar amount that a consumer needs to pay toward any medical expenses initially, before the insurance begins to pay for the services during your coverage period. Following this payment, the health insurance company will then pay off the medical expenses in accordance with the plan.  It is advised that those who have a lot of medical expenses such as frequent doctor visits or purchasing prescription medication, the best option is to opt for a plan with a lower deductible. Learn more!

3. Co-pay and Co-Insurance

Co-pay is the additional cost customers have to pay, after the premium cost. Co-pays apply to every doctor visits, emergency room visits; urgent care visits and prescription drug purchases. Simply, the higher the premium, the lower the co-pay.

Co-Insurance is the remainder medical bill you have to pay after the insurance pays. The percentage covered by the insurance depends on the plan and whether you have met your deductible. For example: Hospital fee is $1000, if deductible is met and co-insurance is 20%, you pay $200 and the insurance will pay the remaining $800. However, if deductible is not met, you would have to pay the full $1000.

4. Pharmaceutical Coverage

Not all prescribed medications or services are covered by insurance. It is important to double check if your drug is covered by your insurance and/or plan. Sometimes, the drug you have always bought was only a few dollars with your old plan but now with the new plan, it’s $100.

5. Dental Benefits

Most dental procedures are not covered by health insurances. It’s best to also shop around for dental insurances whilst searching for health insurances as well. Click here for more information:

Types of Health Insurance Plans

The most common Health Insurance Plans can be grouped into one of three categories:

  1. Indemnity of Fee-for-Service Plans
  2. Health Maintenance Organizations (HMOs)
  3. Preferred Provider Organizations (PPOs)

Not all insurancesare the same. A plan that worksfor you might not work as well for someone else.  Each plan has its advantages and disadvantages. Thus, assessing your medical needs and health situation is very important. Check to see if your providers, hospital and medications are covered. It’sgood to check what your insurance will cover and confirm with your provider that their pricing is in line with what the insurance will pay.



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6 Easy Ways to Change a Health Insurance Plan

Most adults receive health insurance through their employer or through a plan to which they have enrolled outside their employer. It is more common to modify insurance policies, or insurance providers, during open enrollment. Open enrollment is the time of year during which almost all providers allow their clients to change from one insurance policy to another. To modify insurance outside of open enrollment, you must qualify for a certain enrollment period.

Changing Policies during Open Enrollment

1) Find out the Open Enrollment Dates

During the 45-day insurance company’s open enrollment period, you can change your health insurance plans without penalty. The certain dates for your open enrollment period can modify but generally last from the beginning of November until the middle of December. Contact the Customer Service department of your insurance provider to find out the exact dates of Open Enrollment.

2) Review the Available Policies

Insurance companies are generally proactive and must inform their customers about a future open enrollment period by giving information about available policies. Review the available options until you find a policy that best suits your needs. For instance, several insurance policies can cover more than your prescription drug rates, though others can offer a low premium. When your company does not send you information about the policies, contact your customer service department via phone call or email.

3) Choose a Policy

When you have reviewed the different policies offered by your insurance provider, you should choose a certain policy. When you select a policy, consider the amount of money per month you can pay for the premium. Also, consider other aspects: for example, if you understand in advance that you will need common prescriptions, choose a policy that covers all of the costs of prescription medication.

Please note that you cannot change this policy until the next open enrollment period arrives. If the deadline expires or you forget to register completely, you may have to pay a tax fine for not having medical insurance. More details!

Changing Policies Outside of Open Enrollment

4) Look into the Qualifications for a Special Enrollment Period.

Outside of open enrollment, a special enrollment period is a single way to change your health insurance. The exact qualifications of your insurance company to validate a special enrollment period will differ, but commonly include:

  • Marriage, divorce or legal separation.
  • Loss of work.
  • Birth of a child.
  • Death of a spouse.

5) If You Qualify, Contact Your Insurance Company

If you have just had a life event that qualifies you for a certain enrollment, contact your Human Resources representative or your health insurance representative to request information about insurance policies at the ones that could change. Several insurance companies may allow special enrollment for less common life events like obtaining citizenship.

6) Provide Documents that Prove the Life Event

Depending on the event of life that led you to search for a special enrollment period, your insurance company may request documentation verifying the event. This will help the company avoid the delivery of special enrollment periods for fraudulent claims of life events. For example, if you have had a child, your insurance company may need to receive a copy of the birth certificate.

In general, a special enrollment period will last for thirty days. Take this time to review the health insurance policy options available through your insurance provider. Choose an insurance plan that meets your needs. If you cannot pay a lot towards a monthly bill, select a plan with a lower premium. Before the thirty days expires, make your decision and your policy change will be completed. For more information visit:

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