Medical insurance is on our minds a lot this time of year at Horihan Insurance, with the Annual Enrollment Period for Medicare beginning soon, and Marketplace Open Enrollment on the horizon.
Because we know that making decisions about health insurance coverage can be tricky for anyone, we want to provide you with a few reminders and hints to help you toward what you are looking for.
First of all, let’s just face the fact that most people just want to get down to the nitty gritty:
- What’s it going to cover?
- How much will it cost me?
And there’s a lot of wisdom in that. But while low premiums, co-pays and deductibles are great when considering your monthly budget, it is necessary to take a much broader view to really be sure you are getting the coverage that is best for you. Even with a low premium etc., some of the following factors may cause the cost of the coverage you are considering to be more than you had expected in the long run.
- Your personal health history and family health history – What medical problems are ongoing for you or are likely to arise due to genetics that could cause you to spend a lot of time and money at the doctor’s office or the hospital?
- Prescriptions – Are all your current prescriptions covered by the plan you are considering?
- Provider preferences – Often a health plan that seems otherwise perfect for you turns out to not have your local hospital in its network. How much of a problem will this be for you if you need to establish a relationship with a new doctor?
- Travel – Does the plan cover travel insurance when you are out of the country?
Then it is important to consider benefits that are included in the health insurance package you are considering, such as:
- Fitness programs – These programs can be a very effective way of holding medical problems at bay as we age. Having them covered by your insurance can be a huge incentive to use them to your fullest advantage.
- Dental, vision, and hearing – Only some plans in the Health Insurance marketplace cover these things for adults.
- Chiropractic services – This is covered in most health insurance plans but not all.
- Acupuncture and natural medicine – Some forms of treatment are considered too experimental or alternative for the insurance company to cover.
And finally:
- Often, the question of coverage revolves around whether the service or treatment is deemed “medically necessary.” So it is important to always keep account of what your needs are versus how the insurance company may see it. If you have needs that may conceivably cause you to go it on your own for a few things, then it is important to weigh that versus the cost of the plan you are considering and how much you are certain it will.
- Always compare your employer-provided health insurance package with any individual/family and state/federal programs that you would qualify for first. Medicare.gov and the various health insurance carriers’ websites are also great resources when researching.
No matter where you are in your search, Horihan Insurance agents are happy to assist you as you review your options. We work with several carriers and will assist anyone of any age to find the plan that suits your unique situation best.