SubscribeHow to Find the Best Private Health Insurance Plan
Nobody likes shopping for insurance. Especially nowadays when you can be rejected for any little thing you may have had years in the past; or any medication you may have taken. But, insurance is important to have, so, if you don’t have it through our employer, or you are self-employed, it’s best to just get it over with and apply.
Don’t think that just because you are over 40 or over 50 that you can’t get private health insurance. I switched over to a private policy just over a year ago and I’m over 40. I know of several friends who have obtained private health insurance when they were over 40, as well as over 50 years old.
What I did was go online to eHealthInsurance, put in my date of birth and my zipcode and I had many different plans to choose from. I just tested it again and was given 10 best selling plans to choose from, from anywhere from $157 per month to $351 per month. Some were PPO plans and some were HMO. They also have some HSA (Health Savings Account) plan to choose from, as well as Student Plans and Short-Term Health Insurance Plans. I could also click on “All Plans” and was given the choice of 104 total plans to choose from, on up to $1,100 per month.
What’s also good about eHealthInsurance is that they give you the AM Best Rating of the plan, along with customer ratings, and allow you to compare plans. In addition, you can also check which hospitals are covered, and which doctors accept that insurance. And, you can get the quote instantly – you don’t have to give your email out and get a phone call from someone. That’s actually what I like best about the service.
If you want help choosing a plan you can click on “Your Plan Advisor” and you will be asked a series of questions about what you’re looking for. The system then gives you a recommended plan.
Of course, choosing from among 10 “Best Sellers” and 104 total plans can be daunting. What are some things to check out when choosing your own health insurance?
1. The Insurance Company’s Rating
This would be the A.M. Best rating (which eHealthInsurance displays prominently). An A.M. Best rating is an opinion regarding an insurer’s financial strength and ability to meet ongoing obligations to policyholders. You want to stick with companies that have an A- to A+ rating.
2. The Insurance Company’s Record of Complaints at your State Board of Insurance
You can check out complaints against the company by going to your local State Board of Insurance. Of course, every large company will have some complaints, but you want to avoid companies that have a high number of unresolved complaints.
3. The Limits Shown On Your Health Insurance Quote
Check your quote to see if you are comfortable with the benefit levels. For example, a higher deductible will cost less each month. Also, many plans give you a choice to split your medical bills with the Insurance Company either 60/40, 50/50 or 80/20 (with them paying 80%). Then they will have an amount (your stop loss) where they will take over at paying 100% of your covered bills for the remainder of the year. These deductibles and other levels start over every year in most plans. Some plans, though, have a “per cause” deductible, which means you will be responsible for bills up to that deductible for each accident or illness. Make sure you are aware of this distinction, so you can choose a plan that’s right for YOU!
4. The Limits Revealed Within the Policy
Two sections of your policy you want to check are The Benefits and The Limitations and Exclusions. Many of your benefits are actually limited in the Benefits section. For example, diagnostic testing or outpatient treatment may be severely limited. These days, you could have a serious disease such as cancer, and never go into the hospital for it. You could rack up thousands of dollars in medical bills for the diagnostic and follow-up lab tests and MRIs, and then have surgery, chemo, or radiation therapy all on an outpatient basis. Make sure many of these things are covered.
Other items that may be limited are your hospital room rate and intensive care. Your hospital room rate should be at least average semi-private and your intensive care benefit should not be tied to your room rate, but should, instead, be covered as whatever is an average ICU rate for the area of the hospital, also. Some policies limit the ICU benefit to 3 times the regular room rate, when ICU can cost you 10 or 20 times the room rate each day. A short hospital stay with a limit like this in your policy can cost you literally thousands of dollars. A long hospital stay with a limit like this in your policy could drive you into bankruptcy. Even if your policy says it takes over at 100% after $5,000 of covered medical bills, the important term here is “covered” medical bills. If the policy only pays three times the room rate for ICU, then the rest of the ICU bill is considered an “uncovered” charge!
Look out for these types of limits!
Also, be sure to check the Pre-Existing Conditions Limitation if you already have any medical conditions.
5. Be Sure Your Doctor or Hospital is Included
Do you have a specific doctor or hospital that you would like to visit for healthcare? Pay special attention to the network of doctors or facilities that each health insurance plan utilizes. You’ll want to make sure that your favorite doctor or hospital is included on the list for the health insurance plan you choose. Also note that networks utilized by health insurance plans can change, so there is no guarantee that your doctor will always be contracted with your chosen health insurance plan.
There are times, of course, that you have to use doctors that are out of the plan’s network. Be sure your medical insurance quote explicitly states any differences in network costs.
