You and your family definitely need health insurance. The question is, what kind of health insurance should you have, and how much should you pay? The short answer is, it depends.
While the individual mandate of the Affordable Care Act no longer requires everyone to buy health insurance, everyone definitely needs it. Even young, generally healthy and single people can suffer a sudden, unexpected illness or an accident requiring emergency care. Remember that an overnight hospital stay can easily cost several thousand dollars, and that emergency care is the most expensive, per hour or day, of all health treatment.
In short, everyone needs health insurance. The next step is to choose the health insurance plan that’s right for you.
Costs of health care
To decide on which health insurance policy you need, it’s good to understand various health insurance terms. Here’s a primer:
Premium: your monthly payment to the insurance company for health coverage.
Deductible: The amount of the total health costs per year that you will have to pay out of your own pocket before your health insurance kicks in. For example, with a deductible of $2,000, you will pay directly for visits to the doctor’s office, prescriptions and various medical procedures until the total cost reaches $2,000, at which point your insurance company will start paying.
Some plans have different deductibles for different categories of procedures. For example, many insurers have a network of health care providers, and will pay a higher portion of the costs from providers in that network. If you get services from a provider outside that network, you may have to pay more before the insurance will cover any costs.
Co-insurance: In addition to premiums and deductibles, your out-of-pocket costs could also include a co-insurance or co-payment. These can be a flat fee, such as $15 for a doctor’s visit, or a percentage of the cost of a prescription medication.
Out of coverage: There are many things necessary for health care that are not covered by almost any insurance plan. These include over-the-counter medications, such as mild pain relievers like ibuprofen, vitamins, supplements, and often chiropractic treatment.
Generally speaking, the higher the deductible, co-insurance and other out-of-pocket costs, the lower will be your monthly premiums. The challenge is to find the balance between the predictable monthly premium costs and the less predictable out-of-pocket costs that’s right for you and your family.
Choosing a plan
Start with evaluating your own health care needs. You could start by looking at your health history. Add up your receipts for doctor’s visits, prescriptions and other treatments.
However, this is only a starting point. Every major life event will have an effect on your health care needs, and therefore on your health insurance needs. Things like getting married, having children, or even starting a new job could change your health care and health insurance situation.
Evaluate your whole family’s health care needs. Younger children typically require more frequent health care treatments and prescriptions. As you get older, as well, you may require more treatments and medications.
If your family requires more frequent visits to a doctor, or if someone in your family has a chronic health condition, then you might consider a health insurance plan with a lower deductible and copay. On the other hand, younger, healthier people without children could save money with lower monthly premiums, since they’ll be paying for fewer treatments.
Keep in mind that as we get older, our health care needs change, too. Re-evaluate your needs and plan every couple of years, and at every major life event.
Don’t hesitate to ask
Choosing the right health insurance plan can be a challenge. Don’t hesitate to ask for advice and help from experts who can direct you to the right choice for your needs. Call us at Health Choice One.