You need health insurance. But, what is health insurance, and what do you do next.
There is information available on the government’s health insurance marketplace, but you may find that confusing. It’s written in government-talk. There’s also information available from your employer, if your employer offers health care benefits.
To keep your costs low as start coverage, change coverage, it pays to be educated about health care.
Here’s what most people don’t know, and what you need to in order to keep your costs low.
You Have Healthcare Options
The health insurance marketplace was designed to make life easier on you. There are tiers of plans that look like Olympic medals: bronze, silver and gold.
Maybe you’ve read the overviews of the available health care plans, and you’re finding them not particularly helpful.
For example, what even does it mean when a Bronze plan covers 60 percent of your healthcare costs, and when a Gold plan covers 80 percent of your costs?
There isn’t much clarity provided.
Furthermore, depending on which state you live in there, companies compete for your business and “Bronze”, “Silver”, and “Gold” may mean something different to each of them.
In an ideal world, the only difference between a Bronze plan from Blue Cross and one from Anthem would be the cost to be insured. If only it were that simple.
Insurance companies such as Blue Cross and Anthem may cover a particular percentage of your healthcare costs when you choose a Bronze plan or something different, but the way they work their plans are different.
It does matter who you use for your health insurance.
Factors in Determining Plan Costs
Co-pays and co-insurances
Co-payments are the fixed amount you pay your primary care physician or a specialist. However, insurance companies may instead require coinsurance payments. Rather than paying a fixed amount co-payment, you pay a fixed percentage per medical bill.
So, if you have a 30 percent co-insurance, you’d have to pay $60 on a $200 bill, but only $30 on a $100 bill.
People with depression, anxiety or other chronic conditions are used to having to pay for prescription medication on a regular basis. If you don’t have these and rarely get sick, you might not care about how your insurance company pays prescriptions.
However, you’re healthy today. But, what about tomorrow?
Deductibles and maximum out-of-pocket costs
Most times, preventive care and physicals are covered prior to you having to pay the deductible. However, you need to look at the various services you need to pay out-of-pocket first.
What Should I Do About Health Insurance?
To choose the best health insurance, you’re going to have to do some homework.
And, it’s worth it — the most common reason for bankruptcy is medical debt. You don’t want that to happen to you. You’re also going to want to make educated guesses about your income, budget, and medical needs over the next 12 months.
This is actually a lot easier than it sounds. The health insurance marketplace can help.
First, take a look at how many times you went to a doctor or a specialist in the past year, then look at how much you spent on prescriptions. Also, if you can, figure out if you were able to get generic prescriptions or if you paid for brand name drugs.
That’s all pretty easy to add up. Now, compare the health insurance plans.
Multiply the number of doctors’ visits you made over the last year by your expected health insurance co-payment, separating out whatever specialist visits your made. If the plans you’re looking at include a co-insurance, you’ll have to grab some bills and do that math.
Take that amount and add it to the total costs of your prescriptions for the last 12 months.
Those are your basic medical bills. If they start adding up and your head starts to spin, you should look at the most comprehensive plan you can afford on a monthly basis.
Otherwise, check, using the health insurance marketplace, to make sure that your doctors are in-network and go for the plan that, adding medical costs and monthly premiums, gives you the lowest annual bill.