How To Choose A Health Insurance Plan

Health insurance is a way to reduce medical costs to an amount that you can manage by sharing the risk with others. That works because most people are healthy most of the time. So, premiums help pay for the expenses of the small number who are sick or injured.

Here are the three major questions you need to ask when picking a plan.

  • What does the plan cover?

  • How much does the plan cost?

  • Which doctors and hospitals are in the plan?

Understanding the network of a specific plan is key in choosing a new plan in the Health Marketplace. Always check to see if all your doctors are in the plan.  Check to see if your hospitals are in the plan. The plan may also have a drug formulary you need to check.

If a doctor is not in your plan's network, the insurance company may not cover the bill, or may require you to pay a much higher share of the cost. So if you have doctors you want to continue to see, you will want them to be in the plan's network.

Before health reform, companies could sell plans that didn’t cover all types of medical care. For example, some might not cover all doctor visits, or prescription drugs, or maternity care.
That was not good because no one can predict what kind of medical care they might need in the future. The only way to protect yourself financially is to have health insurance that covers every kind of health care.
The new health care laws make sure all the below benefits are covered.
Insurance sold to individuals and small businesses must now cover 10 “essential health benefits."
  • Emergency services
  • Hospitalization
  • Laboratory tests
  • Maternity and newborn care
  • Mental health and substance-abuse treatment
  • Outpatient care (doctors and other services you receive outside of a hospital)
  • Pediatric services including dental and vision care.
  • Prescription drugs
  • Preventive services (such as immunizations and mammograms) and management of chronic diseases such as diabetes
  • Rehabilitation services

For information on specific plans and costs please give us a call. We can help you navigate the new Health Care Marketplace.

Kathy Kessinger 314-962-4995, This e-mail address is being protected from spambots. You need JavaScript enabled to view it










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