Monday, June 18, 2007

Consumer Tips for Health Insurance

A wide variety of health plans and health related services are available to anyone with the time and inclination to take a look. The looking process is often inefficient with your valuable time and it’s imperative in these days of financial roller coaster-ing that you find a cost effective plan that best suits the health care coverage needs of you and yours.

  • Use the following list to help you maneuver through the decisions you will be faced with as you go through your search for the perfect health insurance plan.
  • Ask for advice. The friends and associates you already trust may have the exact health insurance information or tips that you are looking for.
  • Do your research. Before you begin your search, save yourself time by outlining the needs of those who you are purchasing health insurance for.
  • Don’t forget to take into consideration any special healthcare needs.
  • Know your terms. Phrases like HMO, PPO, POS, and Health Savings Accounts should all mean something to you before you begin to look for particular policies.
  • Consider whether or not you are offered a choice in physicians and whether or not you need a referral to see a specialist.
  • Remember that your geographic location may affect the availability of certain health plans.
  • If you are required to choose your provider, make sure that there are facilities accessible and convenient to where you live.
  • Consider the extras that you may want or need, things like therapy, equipment, or a certain doctor that you would like to continue to see.
  • Check out the availability of a prescription plan comes with the policies you consider.
  • Balance premium prices, co-pays, and exclusions to find the right fit.
  • Know ahead of time how to file a dispute with the insurance company should one arise. Make sure that the process is one geared toward expediting the process instead of dragging it out.
  • Remember that individual coverage is more expensive than group coverage but necessary if you are ineligible for any group plans.


  • When you’ve narrowed your choices down to two, compare the following aspects of both:

1. Deductible for individuals

2. Total deductible for the group or family


3. Deductible for providers outside of the network (if not the same )


4. Co-pay amount per doctor visit


5. Percentage of fees that insurance company pays for network providers after the

deductible is met


6. Percentage of fees that insurance company pays for providers outside of the network after the deductible is met


7. Maximum limit per claim


8. Maximum limit per lifetime


9. Medical expenses that will be your out-of-pocket expense


10. Annual fees

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