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Choosing a Health Insurance Plan: Some Tips

published June 25, 2007

( 5 votes, average: 4.3 out of 5)

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"Health insurance" generally refers to coverage of medical expenses including doctors' fees, surgery, drugs, and pathology charges. Health insurance premiums are determined by age, gender, health status, and occupation. Before purchasing any type of health insurance, try to get as much information as possible about the plan you are thinking of buying, and make sure you understand the policy's terms and conditions.

There are various individual health insurance plans offered by insurance companies that provide different levels of coverage at different prices. To understand the benefits covered by various insurance plans, contact the insurance companies. You can also ask the insurance agent who insures your car or house to show you health insurance plans from several carriers so that you can compare them.

First and foremost, when choosing a health insurance plan, you should make sure the plan you choose takes care of your needs. While assessing your needs, consider the changes that may occur in your life due to starting a family, retirement, chronic health conditions, or disabilities you or your family members may have. If care for an elderly person in the family will be required or if you need to cover people who travel extensively, attend college, or spend time in two homes, then special coverage may be necessary.

Find out what the policy covers and what it does not. Note the waiting period mentioned in the policy's terms and conditions. During this period, no claim on the policy will be paid. Make sure you understand the exclusion clauses included in the terms and conditions of the policy.

After evaluating what the plan covers, you will need to find out how much it will cost you. Calculate your out-of-pocket expenses, which include the premium, deductible (the part of the claim that you choose to bear), co-insurance (the amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible), and co-payments (flat fees you pay every time you receive a medical service).

When you receive the policy document, make sure the insurance company offers a "free look" period. Most companies offer a "free look" period of at least 10 days, during which the subscriber can examine the terms and conditions of the policy. If you are not satisfied with the policy's terms and conditions, you can return it to the company and get your premium refunded.

With a clear picture of what each health insurance plan covers and its out-of-pocket expenses, you will be ready to choose the plan that works best for your specific needs.

People obtain health insurance in two ways; they can buy it individually or join a group insurance plan. Employers offer group insurance plans to their employees and their employees' family members. Trade unions, professional organizations, and trade associations also offer group health insurance.

Group health insurance plans are less expensive than individual insurance plans. The sponsors—employers or other organizations—generally pay for the insurance coverage in part or in full. Group plans provide health insurance coverage to individuals regardless of their health status or preexisting conditions. However, the range of health insurance options is limited in group insurance plans.

Self-employed individuals cannot take advantage of group insurance. Such individuals opt for individual medical insurance policies. The advantage of an individual health insurance policy is that the subscriber can select the company from which to buy the plan. He or she can choose from a wide range of insurance plans and a large number of insurance companies in order to find a policy that matches his or her requirements.

Individuals are at a disadvantage because their health histories determine the availability and cost of the policies they can purchase. Insurers may deny coverage based on health status, or they may exclude certain benefits from the policy.
( 5 votes, average: 4.3 out of 5)
What do you think about this article? Rate it using the stars above and let us know what you think in the comments below.