With many insurance companies and various insurance plans, choosing a plan and a company that fits your needs is a daunting task. Even the USHealth Group health plans that appear straightforward have some nitty-gritties that require careful consideration. If you are looking for a suitable health coverage plan, consider the factors below:
1. Network Provider and Plan Type
Insurance companies have a network of pharmacies, hospitals, and health providers they collaborate with. So, before signing up with an insurance company, find out whether your preferred facilities and professionals are part of the insurance company’s network. Remember that in-network medicines and services are within a plan. So, if you get your services outside of the network, you may incur extra out-of-pocket costs. Check if your closest pharmacy or medical specialist is part of the insurer’s network before you sign up.
The amount you pay monthly in the form of premiums is crucial in determining which insurance company to sign up with. Remember, you will pay the premiums whether you get the service or not, and if you stop submitting your premiums, you will not get the cover. The more comprehensive your cover is, the higher the premiums will be.
So you need to determine the health risks you face to help you know which type of insurance cover you need. For example, find out whether the premiums cover your regular prescription if you are on medication. If you want to cover your entire family, the USHealth Group health plans may be your best option, but you have to consider other factors discussed in this review.
Deductibles are the out-of-pocket amounts before your insurance company steps in. For example, if your deductible is set at $1,000, the insurance company will not pay for your medical expenses until your out-of-pocket expenses hit $1,000. These expenses may include procedure fees, special visits, consultation fees, prescriptions, vaccines, and cancer screening.
You will have to cover these costs without sharing them with your provider until you reach the deductible. Note that insurance plans with high deductibles attract low monthly premiums, while those with low deductibles attract high monthly premiums. So, you must balance the deductible with the premium you are willing to pay.
Also check whether the plan you choose has a combined or single deductible for pharmacy and medical services; if not, you will need a separate deductible for your prescriptions. Make sure you know how much you will pay out-of-pocket before the insurance company starts paying for your medical expenses.
4. Coinsurance or Co-Pay
Before you sign up with any insurance company, remember that even after you hit your deductible level, you may still be required to pay some expenses out of pocket. There are two arrangements to take care of this: copay and coinsurance.
Co-pay refers to the flat fee you pay for covered services or prescriptions, while coinsurance refers to the percentage of costs you pay for services and medicines provided to you. Choose the one that’s more favorable to you.
Choosing the right insurance plan is a complex procedure. But you need not go through it alone. You can speak with insurance experts, doctors, friends, and family to help you decide your best plan.