How to Choose a Health Care Plan

Searching for a health care plan can be a nuisance, but health care is a necessity because not having it can be extremely costly. When selecting a health care plan, you need to focus on more than just the premium. The lowest price does not mean you are getting the best deal. In fact, the less you pay, the fewer options you will typically have when choosing a doctor.

To find a health care plan, you should ask people who you know about their plans. You can then easily research the various plans by going on the Internet or by making phone calls and requesting literature. If you have a favorite doctor, you may also want to find out if he or she is in one of the plans that you are considering.

You should also make a list of the medical needs your family has had in recent years and what, if anything, you foresee in the coming years. Does someone in your family require ongoing medical care or treatment for an illness? Are there illnesses that are in your medical histories that may show up in the future? What, if any, medicines are necessary on an ongoing or frequent basis? Once you list the needs of your family, you can look for a plan with those needs in mind.

Among the key questions to ask and issues to resolve when evaluating health plans are:

Out of pocket expenses: These include premiums, deductibles, co-payments, hospital stays and so on. What is and is not covered?

Flexibility: You may want to see a specific doctor in the plan. Can you? Do you need to see a doctor or two or three to get referrals before seeing a specialist?

Communication: You’ll probably need to talk to someone else who uses the plan to determine how easy it is to get a question answered or schedule an appointment. The level and quality of communication between patients and doctors as well as their staff is very important, especially in emergency circumstances.

Out-of-network expenses: If you need to see a specialist and the plan does not have one in your area, or an emergency forces you to the nearest hospital that is not in the plan, will you get coverage?

Preventive care: Does the plan cover routine doctor visits for yourself and your family, including checkups, prenatal visits, and well-baby visits?

Mental health: If you or your family need to visit a psychologist, psychiatrist, therapist or counselor or take antidepressants, is some portion of the payment covered?

Along with the concerns listed above, you may want to ask other people who use the plan about the paperwork and administrative processes — do they bury you under mounds of paperwork? In the end, a combination of costs, flexibility and quality of service — both medical and administrative — are the most significant deciding factors when you are choosing a health care plan.