Health Insurance Tips: Which Plan is Right for You?

by Nick Versaw Updated November 21st, 2021

Health insurance tips: father and son consulting with a doctor

Shopping for individual health insurance can be a scary task. Health care has a lot of moving parts, and it can often feel like you need to be an expert in health insurance to determine what kind of coverage you need. 

Open enrollment periods usually last between two and four weeks, which can create even more pressure when it comes to deciding which health coverage is best for you or your family. 

Despite the confusion and occasional difficulty of navigating the process, choosing the right health insurance is the most important step you can take in reducing the price of future medical bills and avoiding medical debt. 

Fortunately, we can make this process a bit simpler for you. The information in this article will give you some health insurance tips on what you should look for when you’re deciding which health insurance policy is right for you.

Tips for Buying the Right Individual Health Insurance Plan

As we said before, health care plans have lots of moving parts. But you shouldn’t shy away from buying health insurance just because it’s difficult to understand. 

Health care costs, from the price of basic medical services, to the cost of common prescription drugs, can be very expensive when you forego health insurance. If you are looking for an individual health insurance plan, here are some health insurance tips to consider before you start.

In addition, having a quality insurance plan has many long-term health benefits, including the opportunity to participate in wellness and mental health programs that can benefit you as you grow older. 

What Do You Think Life Will Bring Over the Next Year?

Sure, your health care coverage ought to prepare you for dealing with the unforeseen — but you can control how much you’ll pay by identifying in advance the things you know you’ll need. 

If you plan on starting a family, or already have dependents, for instance, you should plan to purchase health insurance that will cover those related expenses. Before choosing which type of plan to utilize moving forward, review the summary of benefits carefully to make sure pregnancy and prenatal care are among the coverage options. 

Among the important health insurance tips for singles: medical insurance coverage reserved for individuals can often adequately cover your medical care costs with lower monthly premiums.

If starting a family is not something you expect to do in the next year, you can save money by not buying an insurance plan that covers those costs (just keep in mind that if that happens unexpectedly, you’ll have some serious out-of-pocket costs).

Knowing that you’ll need a plan that covers treatment for pre-existing conditions like diabetes, heart disease, etc. is also important. If you’re already receiving care for such a condition, then you’ll need it going forward and it’s something you’ll have to pay attention to as you compare health insurance plans

It’s mandated by the Affordable Care Act (ACA) that all individual health insurance plans pay for preventative care measures such as cholesterol screenings, mammograms, and other similar services. You can learn more about what services and options individual health insurance plans are required to offer at healthcare.gov. Under the ACA, individuals and families can determine their plan eligibility based on their income. 

Pay for the Right Amount of Coverage

Health insurance tips: couple consulting with an insurance agent

Health insurance coverage isn’t something you should skimp on, but it doesn’t have to cost you a fortune either. Some coverage may be more than you need, and some health care plans may offer more than is necessary for where you are in life right now. When you’re researching plans on the Health Insurance Marketplace, be sure to carefully read what’s included in the packages in your budget range to make sure you don’t pay for something you really don’t need.

Know Who’s in Your Network

If you have doctors or specialists who you are currently seeing and would prefer to stay with, then find out whether or not those medical providers are part of your new plan’s network before you buy. One important health insurance tip to remember is that if your doctors are outside of your policy’s network, you could end up footing a larger portion of the bill. Sticking with network providers is one of the first things patients can do to reduce their medical expenses.

Are Your Prescriptions Covered?

If you already use prescription medication on a regular basis, you’ll want to make sure that the medication you’re currently taking is covered under your selected health insurance plan and that the copay (what you pay out of pocket) is reasonable. Remember, health insurance companies are not required to offer prescription drug coverage. Just because you sign up for health insurance doesn’t necessarily mean you have it. 

How Much is the Deductible?

Many policies require that you pay a deductible before your coverage kicks in. That means that you must pay a certain amount of a given health care expense, and anything left over after your payment will be covered by the insurance company

Make sure that you can afford to pay the deductible on the health care plan you’ve chosen. Also, find out if any costs are excluded from the deductible. Some things you may have to pay for out of pocket may not count towards your deductible, which means you could end up paying even more. 

On the other hand, health care plans with a higher deductible will have lower costs, including lower monthly payments, or premiums, than low-deductible plans.

Generally speaking, younger people benefit more from high-deductible health insurance plans because they go to the doctor less often and should have lower health care expenses as a result. Their health insurance plan would still be there to cover them if something unexpected happened, such as a medical emergency.

Compare Prices and Policies

Don’t just look at how much the premium will cost. When considering which health insurance plan to purchase, make sure policies are similar. Look at the items discussed above and compare those points between the two policies. Consider what you’d be willing to give up in favor of a less expensive health insurance premium. Think about what you can’t live without and whether you’re willing to pay a bit more for it.

Individual Health Insurance Shopping Can Be Easy

Nurse happily attending to her patient

Sure, there’s going to be some legwork involved, but it’s not as hard as you may have thought it would be. Hopefully, these health insurance tips will help you get through the process easily and without too much confusion. 

Even with insurance figured out, individual medical procedure costs can still be murky. There is supposed to be transparency in health care, but many hospitals still make pricing guides hard to access. To explore the cost of common medical procedures in your ZIP code, check out this simple procedure cost comparison tool

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