Health insurance is a necessity in life today, even for young people with good health. Health costs without insurance can be crippling and their financial implications devastating. Therefore, there is need to reduce them to a manageable amount while sharing the risks with others.
This is effectively taken care of by insurance companies. These companies work on the premise that most people are predominantly healthy most of the time, and so their premiums can be used to take care of the health costs of the small number who are sick or injured.
The expenses, complexities, and exclusivity involved in health care make health insurance an absolute necessity. With health insurance enrollment comes the necessity to choose the best health insurance provider possible.
What sets good insurance companies apart from the rest is their ability to come up with plans that are specific to their clients’ needs while also taking care of their financial concerns. Your health insurance is as good as the company behind it.
Some of the things to consider when enrolling for a particular plan include:
Category – Most insurance providers offer insurance plans in five categories generally referred to as metal plans, with their quality corresponding to the value of the metal type used to represent them. The plans are Bronze, Silver, Gold, and Platinum categories. In addition to these basic categories, people below 30 years and those with hardship exemptions can enroll into the catastrophic program.
Premiums – Health insurance premiums are mostly paid monthly. These premiums are important in helping you choose the insurance plan that is most financially sound for you. They are, however, not the most important consideration as lower premiums could mean higher out of pocket costs when in need of care, and higher premiums imply lower out of pocket costs.
Out of pocket costs – These refer to outlays of cash when in need of healthcare that are not later reimbursed by the healthcare insurance provider. They include all payments for services not covered, collectibles and deductibles. Categories with lower monthly premiums i.e. bronze, silver and catastrophic plans generally have higher out of pocket costs.
Type of plan and network of provider – Under the metal plans, providers include different types of plans detailing different options, as in whether or not they cover costs incurred when dealing with doctors and providers outside the provider network. Some plans offer only to pay for costs incurred when dealing with providers outside the network while some only pay for within-network costs with the exception of emergencies.
Benefits – The Affordable Care Act of 2014 details the essential services that should be offered by the healthcare insurance plans. These essential services include emergency services, pregnancy, maternity and pre and ante natal care, hospitalization, ambulatory services, prescription drugs, chronic disease management and preventive and wellness services, outpatient care, laboratory services and pediatric services.