October 14th, 2010 
Vijaianand In the last post, we saw the recent Health Act law changes went effect from Sept 23,2010 and more such changes are going happen for the year to come. Whether full health care bill takes effect in 2014 or not, these small changes really helps many families to maintain their health insurance coverage. If you are individual who don’t work for any big companies that offers group health coverage and been contemplating about taking individual coverage, this may be right time before the premiums go up as many expects.
For the household which has group insurance coverage, open enrollment is right around the corner. That mean’s it’s time to start thinking about choosing your health plan for next year. Some of you might have option to select from different providers and plans but some might not have lot of wiggle room except choosing from two different plans. It all depends on your employer. But if you are individual/family without an option for getting group plan and looking to carry individual insurance you have all the options in the world.
1. What’s your status?
First, think about your current status. Are you single or married? Do you have dependents in your household who needs medical help. It matters because it determines whether you need a plan for one or a family member. Also the status will affect your cost and your health coverage. So be careful to see which plan options best suit your situation.
2. What’s the cost?
Secondly comes the cost. There are a few big things to consider about cost. Do you or your family go to the doctor often? Then you might want a plan with a lower deductible and out-of-pocket cost and a higher monthly premium. If don’t use your health plan or go to the doctor much? It might be better to choose a plan with a lower monthly premium and higher deductible. I like to categorize them as, Pay first Plans and Pay later plans.
You either pay ahead as premiums if you need lot of medical help and save money on deductibles or pay later when things happen and save money on paying high premiums. It depends on your situation. I prefer to go with Pay later plans that way you have more flexibility but you need to plan for those expenses and put away the money aside for deductibles/coninsurances.
If you’re not sure what might be best, look at what you spent last year and how often you or your family went to the doctor. By doing your analysis and then you can choose a plan that fits your needs.
3. Who’s in the Provider network?
Third comes the provider network. Check out whether your favorite doctor is “in network” for the plans you are looking. How about specialists and hospitals nearby your area? Some don’t want to lose their favorite doctors or pediatricians while changing the plans but most of the PPO plans from different providers are pretty flexible and coverages well know doctors and clinics. But it is always better to make sure by calling the doctors office before you deciding on a particular plan.
4. Are there other benefits?
Many providers offers plan with paid preventive coverages with certain limitation and also offers wellness programs like reimbursing for fitness clubs memberships, covering certain weight loss programs. This will be the fourth step in your plan selection process. It is common belief that one lives healthier avoids getting sick often and will have less medical problems, that reduces number of visits to hospitals and doctors and insurance companies can reduce their cost. At the same time, as a person it is important to get support to lose weight, eat healthier or stay fit. It is a win win for both insurance companies and individuals. So make sure you take a look at the wellness options.
5. Is a healthcare fund (FSA/HSA) right for you?
Finally comes some many saving options. If you currently have healthcare insurance through your employer, you might have heard about FSA cafeteria plan(FSA). This plan is offered seperately apart from your Health insurance. If you have the option to enroll in this funds, please consider it. It could help you save by paying for care with pretax dollars. Similary, HSA (Health Savings Account) also helps save money by paying premiums and deductibles from Health Saving account where the contributions to them are tax deductible and also has flexibility to earn some interest which can be withdrawan tax free when used for medical expenses. You can learn more about these plans at planforyourhealth.com.
Health problems/issues can be devastating at times and has the power to wipe out your full assets in matter of months. It is wise to have a Health insurance with reasonsable coverage to cover you and your family both for the physical and financial well being.
Some content courtesy: Aetna Newsletter
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