5 Things to Consider While Buying Your Health Insurance

Apr 19, 2023 / Amity Insurance Group

You must have a health insurance plan that offers adequate coverage for expected and unexpected healthcare expenses for you and your loved ones. The right health insurance also allows you to receive the best available medical treatment without causing a massive dent in your financial resources.

This blog discusses the 5 things you must consider when looking for health insurance coverage options before selecting the plan that aligns with your unique needs and budget.

5 Important Factors to Look for When Buying Health Insurance Plan

When you buy health insurance, you must consider five factors to ensure that the plan is best suited to your health needs and you enjoy peace of mind that you are financially secure for the coming year.

Health Plan Category

Health insurance plans are available in 4 categories: metallic tiers, Platinum, Gold, Silver, and Bronze. All plans cover the same healthcare services but differ in premiums and covered expenses. For example, with Platinum and Gold plans, you pay higher premiums and receive higher compensation from your plan towards medical costs. If you are under 30, you can also buy a high-deductible catastrophic plan.

Based on the monthly premium, deductible and co-pays, provider network, and prescription drug coverage each plan offers, you may select the category of your choice.
Healthcare Plan

The 4 standard plans for your healthcare needs are:
- Health maintenance organizations (HMOs)
  You have access to healthcare providers and services offered within the network. You may need a referral from your primary care physician for specialist consultations.
- Preferred provider organizations (PPOs)
  Besides the in-network services, you can access out-of-network medical providers and facilities at added costs.
- Exclusive provider organizations (EPOs)
  Your healthcare choices are exclusive to the in-network services offered except for emergencies.
- Point-of-service (POS) plans
  It combines features from HMO and PPO, where you have a primary care doctor for your needs who can refer you to a specialist. Out-of-network services are available with lesser formalities and costs than PPO.
After weighing the benefits provided by each plan, it is easier for you to select the right plan based on your needs.
In-network Services

Before buying a health plan, you should ensure that your preferred provider, hospital, and pharmacy are within the network offered in the plan or that the in-network healthcare services are easily accessible to you.
Extent and Type of Coverage

You may need specialized coverage such as preventive care, emergency services, hospitalization, and wellness programs for your health-specific needs. Also, each insurance provider has a formulary or a list of covered medicines. This makes it essential to examine the coverage types and the inclusions in your coverage to receive maximum benefits from your plan.
Insurance Costs

The premiums must be within your budget, as a lapse in payment may result in the cancellation of your plan. Other costs include deductibles, copays, and coinsurance.