How to Choose Your Best Option for Health Care Coverage

How to Choose Your Best Option for Health Care Coverage
How to Choose Your Best Option for Health Care Coverage

Health insurance can be complicated. When you’re presented with options through work every year or you are looking at your options online, how do you know you’re choosing the right plan? With the right company? There are many choices involved in finding the best health care coverage for you or your family, and the first step to making the right choice is knowledge.

Online reviews and articles offer thousands – if not millions – of real customer experiences. Customers leave feedback about insurance companies and processes in consumer reviews on the insurance websites as well as individual review websites. Before looking at the individual options on each insurance plan, consider reading health insurance reviews from customers about the companies – especially if you have a choice between different providers.

Review websites like offer customer feedback about insurance companies and how they work. Once you have found the best health insurance companies from the choices you have and checked customer feedback and reviews, it’s time to dig into the various plans to find what best suits your family.

Monthly Premiums

The first thing most people consider when shopping for a new insurance plan is the monthly premiums. How much is it going to cost me every month to have this insurance? The monthly premium is just that – a premium. It is not a cost that is applied to your coverage, and the money only guarantees that you have the coverage you’re paying for.

Many buyers assume that expensive premiums guarantee excellent insurance coverage, but that isn’t always the case. Look at the total cost of how much you’re paying every month in premiums over the year. Then look at how much you’ll pay out of pocket for health care services and prescriptions. It may make more financial sense to pay less every month for a plan with a higher deductible. If you pay an extra $200 per month for a higher premium, it doesn’t count against a $1,000 deductible. If you pay an extra $200 per office visit toward your deductible of $1,500, you’ll potentially pay less over time for medical care and prescriptions.

Maximum Out of Pocket

When choosing health insurance coverage, the maximum out of pocket is essentially the bottom line. How much will you be obligated to pay if you wind up in a serious medical situation? If you know that you will be visiting with specialists, have expensive medical treatments, or that you’re planning a procedure, costs will add up quickly. You and insurance will share the costs of these treatments through co-pays and insurance payments, but eventually, a year of expensive medical treatments will “max out” your insurance and you will have hit the payment threshold.

For example, one medical plan may have a maximum out of pocket limit of $5,000. Another plan might have a limit of $10,000. A week in the hospital or a major surgery will likely cost more than $10,000. With the first plan, you’ll pay your share of the expenses up to $5,000, and insurance covers the rest. With the second, you’ll be paying $10,000 before insurance steps in to cover the remainder of the payments. In most cases, the monthly payments of your insurance aren’t being counted against your maximum out-of-pocket. Co-pays, on the other hand, are.


The deductible is the amount of money you’ll have to pay before insurance starts to cover costs for medical treatments. In a high-deductible plan, you may be paying thousands of dollars before insurance gets billed for anything. Typically, the higher the deductible, the lower the monthly cost of the insurance plan. The monthly payments don’t apply to the deductible, however.

When researching insurance, look for wording like “after deductible” or “after meeting deductible.” For example, a sick visit to the doctor might be covered “at 80% after meeting the deductible.” If the deductible is $1,000 for the year, you will pay the full price of every appointment until you’ve paid $1,000 and then insurance will step in to cover its 80% of remaining trips throughout the year.

Prescription Coverages

Having health insurance isn’t just about going to the doctor when you feel sick. It’s also about helping cover the costs of ongoing medications. Sixty-six percent of Americans use at least one prescription drug regularly. The worst health insurance option for someone who has expensive medications may be one that doesn’t help cover the costs of any of those drugs.

When researching insurance companies, look beyond the numbers for co-pay and deductible and see how much is covered for medications. Some insurance programs will only cover generic medications instead of a  brand name. Some companies have tiers of medications and won’t cover the costs of certain medications if they deem the cost is too high. Some companies include prescription payments as payments toward the maximum out-of-pocket and the deductible, but others do not. Read the fine print on prescriptions to be sure you’re planning for costs you know you’ll be incurring.

There are many other factors to consider when reading through insurance reviews and facts online. You want a company that is honest and dependable. Transparency when it comes to costs and coverage is key to finding a company that you can trust, and insurance reviews are one of the best ways to see how others have fared with a particular company or insurance plan.

Insurance is expensive for most of us. Chat with others in the company if you’re reviewing work insurance offers. Check forums for reviews from actual customers. Bring out a calculator and do the math necessary to be sure you’re getting the right insurance plan that is worth the price you’re paying.

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