6 Questions to Ask Before Purchasing Health Insurance

Health insurance policies provide a surefire way for you and your family to receive excellent medical care in case of illnesses. It also prevents you from spending a fortune in the event of expensive medical emergencies or chronic illnesses. 

Health insurance in USA is necessary as some healthcare facilities will be reluctant to offer treatment if you do not have a plan.

Taking the step to get health coverage is applaudable and one of the best decisions to safeguard your finances. Nevertheless, considering many insurance companies promise excellent services, finding an ideal one can be a daunting task.

This article focuses on crucial questions you must ask before buying an insurance cover.

Let’s dive into the finer details.

• Which is my Ideal Health Insurance Plan?

The government and private non-profit organizations offer health insurance in the USA. As such, you need to decide the best for you.

Medicare and Medicaid are two of the most popular federal health insurance programs for US citizens. However, Medicare is only available to seniors aged 65 years and above. It also covers young people with certain disabilities including end-stage renal disease and amyotrophic lateral sclerosis – a disease affecting the nervous system.

On the other hand, Medicaid is an insurance plan that covers US citizens with a low income. Persons who qualify for Medicare can have Medicaid coverage which offers additional services such as personal care services.

Children’s health insurance program is another federal plan covering children from families whose income is slightly higher to qualify for Medicaid.  

Last but not least, we have private health insurance plans that offer a variety of coverage. The monthly premium payable depends on various factors, including your medical history, services to be covered, the number of dependents, and many more.

• How much are the Monthly Premiums?

The premium is the amount of money you should pay to your insurance provider monthly or as agreed. The amount to pay depends on the services the plan covers. For instance, if you want dental, eye examination, and physiotherapy services, you will part with more money as compared to persons with basic plans. 

Health insurance policyholders should religiously pay the premiums as agreed, whether they are using the cover or not. Failure to which, they risk losing their coverage. So, the importance of choosing health insurance that you can easily afford is of the utmost importance.  

Additionally, apart from the monthly premiums, insurance holders are also required to pay deductibles which leads us to the third question.

• What About the Deductibles? 

Every policyholder must understand that they are expected to pay their medical bills up to a certain amount before the health policy takes effect. Hence, what’s known as deductibles.

Deductibles are the out-of-pocket payments you make before your insurance policy can disburse funds towards covering your medical expenses. These amounts vary from one insurance company to the other – a vital reason why it should always remain top of mind as you shop for your ideal plan.

For better understanding, let’s get practical.

For instance, your deductible is $500, and you fell down a fleet of stairs and broke your arm. If your medical expenses total $400, your insurance plan will not cover the costs, and you will have to pay out-of-pocket. However, if complications arise, you go back to the hospital a second time, and the treatment costs total $300, you will only pay $100, and the insurance company will settle the rest.

However, note that even after meeting your deductibles, some insurance companies will not settle the entire amount but only a percentage. As such, we cannot over-emphasize the need to understand the terms of the policy in depth. 

• What’s Their Provider Network?

Insurance companies get into contractual agreements with doctors, hospitals, and various healthcare facilities, otherwise known as in-network providers. When you take out a plan, your insurance company will only settle medical expenses incurred within their network of healthcare providers. 

Hence, when picking a suitable healthcare cover, you need to consider if your preferred hospital, doctors, and healthcare facilities are among the in-network providers. If they are not, you have two options: you can either look for an insurance company that accepts them or switch to the company’s in-network providers.

• What’s their Prescription Drug Coverage?

Especially if you are suffering from chronic and other prolonged illnesses, you may need various drugs to manage or treat the condition. Considering that you may be consuming these drugs a couple of times a day and maybe for extended periods, medicine expenses can escalate fast.

The same applies to short-term illnesses and emergencies as your doctor might prescribe expensive medication. And if you happen to visit the hospital a couple of times a year, drug expenses might set you back a couple of hundred dollars.

For this reason, getting to know a policy’s prescription drug coverage is imperative. 

Before purchasing the policy, take a keen look at their formulary – a list of drugs that the insurance plan covers. Make sure the list is inclusive of the medication you take. If not all are available, look out if they can at least provide the most expensive ones.

• What about Additional Incentives?

With the influx in health insurance companies, it is no longer business as usual. More health insurance companies offer additional services to establish their authority and attract a vast clientele. Some policies will cover wellness programs, free counseling programs, and many more.  

As you shop around for an ideal policy for you and your family, also consider these additional perks as they may come in handy.

Conclusion

These are the six most essential questions you should ask before purchasing health insurance. Your health is a matter of life and death, and a health policy is a lifetime commitment. So, do not settle or compromise. Schedule consultations with as many health insurance companies as you can until you find one that is your perfect fit.  Once you narrow your choice down to three, make sure you check the company’s credibility, business volume, and claim settlement ratio.