How to choose the right health plan

Comparing health plans offered by different health insurance companies used to be very difficult because health plan benefits were widely different between insurance companies and there was no standard across the industry. Since Obamacare standardized the benefits, it’s much easier now to compare plans. Under the Obamacare, health plans are categorized by “metal level”, that are Platinum, Gold, Silver and Bronze, and all health plans must cover “Essential Health Benefits”.

When you get quotes of several health plans that meet your criteria, such as your budget for a monthly premium, network of doctors & hospitals, consider the following important points:

  1. PPO or HMO – Is your primary care doctor and specialists in the Network? If you have to see an out-of-Network provider, will the policy still cover the cost?
  2. Annual Deductible
  3. Annual out-of-pocket maximum – If you incur a large medical expenses during the year, how much can you pay out-of-pocket?
  4. Metal Level – Platinum level plan will cover approximately 90% of the medical cost, Gold will cover 80%, Silver will cover 70% and Bronze will cover 60%
  5. Office visit co-pay
  6. Prescription drug co-pay
  7. Co-insurance
  8. Alternative Medicine coverage (Chiropractic, Acupuncture, Natural Medicine, etc. ) – If you use the alternative treatments frequently, you may want to have them covered by your health plan
  9. Consider HSA plan? – HSA-compatible plans will permit you to have a HSA (Health Savings Account). It may be beneficial for you depending on your situation.

Back to Home