Purchasing a personal health care policy can be scary for anyone who
has always been insured by their employer’s group insurance plan.
I’ve specialized in helping clients select good quality health care
coverage for well over ten years now and have been an insurance broker
for over 20 years. I’d like to share with you the process I use when
helping my clients find the best health insurance plan to cover
themselves and their families.
The three areas we look at are affordability, quality of coverage and the quality of the insurance carrier.
Company- Your health insurance carrier should be stable financially and have a history of paying claims.
Coverage - The medical coverage must meet your needs. It should cover doctors, hospitals, labs and drugs. It should also have physicians and hospitals in their networks that are convenient to your home.
Affordability- Your healthcare plan must be priced fairly relative to the benefits provided.
The basic process we use is to:
Determine which individual or family medical companies are worthy of being considered.
Determine which choices offered by those healthcare companies offer proper coverage
Determine which choices have the lowest overall cost relative to the health insurance benefits provided
Health Insurance Companies
A personal healthcare insurance company should have good financial ratings and be in good standing with your state’s insurance department. You may also want to do a web search for complaints.
You might for example type in "Mega Insurance complaints" before buying a policy from them. Each healthcare carrier has some complaints just by virtue of the volume of clients they have. That being said, a be warned if there are too many complaints.
One more issue to look at is how much they pay in benefits as a percentage of the premium they take in. A typical company will pay out about 80% of the money they take in to cover their clients’ healthcare procedures.
Level of Protection - What does the medical plan cover?
There are 2 important aspects of coverage. One is the treatments that are paid for by the plan. The other is the network’s list of medical professionals that the insurance plan includes.
Covered Medical Procedures
Your medical insurance plan should cover you in both the doctor’s office and the hospital and should have a good lifetime maximum benefit. I suggest at least five million in coverage. You should read through your insurance plan’s outline of coverage or official brochure to see how doctors, hospitals and prescriptions are covered.
Health care Insurance Exclusions and Limitations
Most if not all healthcare insurance plans will have a list of treatments and services that are not covered. Most of the excluded or limited items in this section are reasonable and are included in the policies of most carriers also. Plans usually will not pay for a nose job for example. There are are often limitations that you may find in one insurance policy but not in another plan. Pregnancy coverage is one example of this. Generally insurance plans will not cover the costs of a child birth. The ones that do will be more expensive when compared to otherwise similar plans that don’t cover maternity. The exclusions and limitations section of your policy or its out line of coverage should be read carefully before you make your decision about purchase.
Healthcare Insurance Networks
Knowing which physicians are in your medical insurance carrier's network is important. You might be able to find a list of doctor’s who accept a given insurance plan online or by calling your health care insurance agent.
Dollars and Cents – Finding the best low cost medical plan
It is easy to compare private health insurance costs, but its harder to make sure that you are getting good coverage for your dollars.
Comparing Health Care Insurance Policies
Not until you have crossed the plans on your list that have bad coverage and/or a lousy list of doctors should you start comparing the prices of the plans
The Best Health CARE Insurance Coverage for the Money
The best health care insurance coverage, may not be the best plan for you. Often the best plan is overpriced and does not offer coverage that justifies the extra that it costs. Make sure that any plan you buy is:
Provided by a good health care insurance carrier
Will cover your health needs well
The three areas we look at are affordability, quality of coverage and the quality of the insurance carrier.
Company- Your health insurance carrier should be stable financially and have a history of paying claims.
Coverage - The medical coverage must meet your needs. It should cover doctors, hospitals, labs and drugs. It should also have physicians and hospitals in their networks that are convenient to your home.
Affordability- Your healthcare plan must be priced fairly relative to the benefits provided.
The basic process we use is to:
Determine which individual or family medical companies are worthy of being considered.
Determine which choices offered by those healthcare companies offer proper coverage
Determine which choices have the lowest overall cost relative to the health insurance benefits provided
Health Insurance Companies
A personal healthcare insurance company should have good financial ratings and be in good standing with your state’s insurance department. You may also want to do a web search for complaints.
You might for example type in "Mega Insurance complaints" before buying a policy from them. Each healthcare carrier has some complaints just by virtue of the volume of clients they have. That being said, a be warned if there are too many complaints.
One more issue to look at is how much they pay in benefits as a percentage of the premium they take in. A typical company will pay out about 80% of the money they take in to cover their clients’ healthcare procedures.
Level of Protection - What does the medical plan cover?
There are 2 important aspects of coverage. One is the treatments that are paid for by the plan. The other is the network’s list of medical professionals that the insurance plan includes.
Covered Medical Procedures
Your medical insurance plan should cover you in both the doctor’s office and the hospital and should have a good lifetime maximum benefit. I suggest at least five million in coverage. You should read through your insurance plan’s outline of coverage or official brochure to see how doctors, hospitals and prescriptions are covered.
Health care Insurance Exclusions and Limitations
Most if not all healthcare insurance plans will have a list of treatments and services that are not covered. Most of the excluded or limited items in this section are reasonable and are included in the policies of most carriers also. Plans usually will not pay for a nose job for example. There are are often limitations that you may find in one insurance policy but not in another plan. Pregnancy coverage is one example of this. Generally insurance plans will not cover the costs of a child birth. The ones that do will be more expensive when compared to otherwise similar plans that don’t cover maternity. The exclusions and limitations section of your policy or its out line of coverage should be read carefully before you make your decision about purchase.
Healthcare Insurance Networks
Knowing which physicians are in your medical insurance carrier's network is important. You might be able to find a list of doctor’s who accept a given insurance plan online or by calling your health care insurance agent.
Dollars and Cents – Finding the best low cost medical plan
It is easy to compare private health insurance costs, but its harder to make sure that you are getting good coverage for your dollars.
Comparing Health Care Insurance Policies
Not until you have crossed the plans on your list that have bad coverage and/or a lousy list of doctors should you start comparing the prices of the plans
The Best Health CARE Insurance Coverage for the Money
The best health care insurance coverage, may not be the best plan for you. Often the best plan is overpriced and does not offer coverage that justifies the extra that it costs. Make sure that any plan you buy is:
Provided by a good health care insurance carrier
Will cover your health needs well
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