5 Things to Consider When Choosing Health Insurance
Learn about some of the factors that can affect your costs and coverage.
It’s easy to get overwhelmed when you have to choose a health insurance plan. There are so many factors to consider, from how much you’ll pay to which services the plan covers. The decision-making process can be even more challenging if you have family members with different health needs.
Here’s a quick guide to help you choose the best plan for you and your family.
1. Consider your health insurance costs
Health insurance is a safety net that shields you from costly treatments for illness or injuries. But it also costs you money because of monthly premiums, copays, deductibles, and coinsurance. Let’s break down the costs.
Monthly premiums
You pay a monthly premium to keep your health insurance policy active. If you have an employer-sponsored health plan, it’s different. Your portion of the premium comes out of your paycheck, and your employer pays the insurance company on your behalf.
If you have private insurance or choose a plan through the Health Insurance Marketplace® or state-based marketplace, you will pay your monthly premium directly to the insurance company.
Copays
Copays are a set amount you pay for certain healthcare services. These services may include visiting your primary care provider or getting a prescription. The amount may differ based on the type of service you need.
When you see a specialist, such as a cardiologist or a dermatologist, you may pay a higher copay than when you see your primary care provider.
Deductible
A deductible is the out-of-pocket amount you pay for covered healthcare services before your insurance kicks in. For example, if your insurance plan has a $1,000 deductible, you’ll pay the first $1,000 for certain services. Then, your insurance will start to cover some or all of your costs. Once this happens, you’ll still be responsible for copays. Your deductible amount resets every year.
Coinsurance
Once you meet your deductible, you will owe coinsurance for healthcare services. This is typically a smaller percentage of the cost of the service. For example, if your dermatologist recommends taking a biopsy of your skin, your insurance would pay 80% of the allowed amount and you would be responsible for the other 20%.
Each plan and even service will have different coinsurance percentages, so make sure you consider that in your health insurance search.
Related: 7 Health Insurance Terms You Should Know
2. Identify what health services are covered
Certain life changes can impact your healthcare needs and costs. Are you planning to have a baby? Do you expect to need surgery? If so, you may need different coverage than other people. Review plans to see which one best fits your current or future situation. Make sure you understand any out-of-pocket costs or coverage considerations to avoid surprises down the road.
Compare Select Health plans to see what works for you.
3. Manage your costs with an HSA or FSA
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are not health insurance. But they can help you manage your healthcare costs.
What is an HSA?
An HSA is a savings account for people with high-deductible health plans, or HDHPs. HDHPs are health insurance plans with lower premiums and higher deductibles than traditional plans.
If you have an HSA, you can set aside pre-tax dollars to pay for qualified medical expenses. In addition, the funds you set aside can roll over year after year. HSAs are a good choice for those who want to save for future healthcare expenses.
What is an FSA?
You can put pre-tax money aside in an FSA to save on out-of-pocket healthcare costs. You typically must spend FSA funds within the plan year. If you don’t, you may lose that money. FSAs can be great for people who know they’ll have ongoing healthcare costs, such as prescriptions and recurring medical treatments.
4. Save money with many types of health insurance plans
Many insurance companies reward members who engage in healthy habits and preventive care. These incentive programs help you manage costs while encouraging overall well-being. For example, Select Health offers wellness rewards with certain types of coverage.
From discounts on gym memberships to rewards for completing health assessments, these rewards may lower your healthcare expenses.
5. Compare health insurance plans. We can help.
Finding the right health insurance plan can feel complicated, but there are tools to help you make a confident decision. Whether you're choosing coverage for yourself, your family, or your business, it's important to compare benefits, costs, and provider networks.
Visit SelectHealth.org/Plans to view different health insurance plans. If you’d rather talk to a knowledgeable agent, you can call 800-538-5038 Monday-Friday from 7a.m. to 8 p.m. or Saturday from 9 a.m. to 2 p.m.