• Insurance, Advice

How to evaluate a healthcare plan & find one that's right for you

It’s that time of year enrollment season!

Open enrollment began November 1st, 2015 and ends January 31st, 2016. But, never fear, we at Freelancers Union are here to assist you in evaluating a healthcare plan that works best for you.

As experts in healthcare, with over 14 years experience connecting freelancers to the right insurance plans, our goal is to make this process as anxiety-free as possible.

There are many places you may be looking to get your health insurance–and with so many options, it’s not unusual to feel overwhelmed. Wherever you shop, it’s vital that you consider each choice carefully.

The first step of evaluating which plan is the right fit for you is understanding that the insurance plans are grouped into five metal tiers: Catastrophic, Bronze, Silver, Gold, and Platinum.

The plans tend to be more expensive upfront the higher you go up the tier, but they also tend to offer more coverage. The Catastrophic and Bronze tiers cover a smaller part of your yearly medical expenses and they have a lower monthly premium.

But how to choose the best plan?

The first thing you can do is make a list of the things that you feel are vital to your healthcare plan. It is also important to consider both your medical and financial needs. This will allow you to choose a plan where you feel safe in your coverage but not fiscally strained.

What to consider, while keeping this helpful glossary on hand:

The costs associated with the plan

First, familiarize yourself with the terms:

  • Copay: A fixed dollar amount that you pay out of pocket for a medical expense.
  • Premium: What you pay each month in order to purchase insurance. This is, roughly, the “cost” of your plan.
  • Coinsurance: The percentage of a medical expense that you are responsible for paying. The insurance company pays for the rest, hence “co-insurance.”
  • Deductible: The amount you are responsible for paying towards medical expenses before your insurance coverage “kicks in” to pay the rest. This resets every year.
  • Maximum out-of-pocket: The maximum amount you will be responsible for paying toward medical expenses covered on your plan.

The overall cost of your health insurance plan is typically a combination of the various pricing factors listed above. For example, plans with higher premiums (monthly payments) will frequently have lower copays and deductibles.

If you expect to have a lot of medical appointments in the next year, you may want to sign up for a plan with a higher premium and lower copays.

Check prescription drugs coverage and cost

Each plan has a Prescription Drug List of covered medications. The medications are grouped into tiers based on cost. Some plans will have lower cost thresholds than others.

Check the Prescription Drug list associated with the plans you’re considering to determine whether your medications are covered.

Access to doctors and care facilities

Every plan has a network of providers, which includes doctors and care facilities as well as labs, pharmacies, and imaging centers.

If your regular doctor is not in the network of your plan, it’s likely to cost you more to visit. Be sure to call your doctor before switching plans to confirm that they will take your new insurance.

If you don’t have a regular doctor, it’s still important to evaluate the network based on travel times and location as well as peer reviews of the care providers within the network you’re considering.

Don’t be afraid to make a call to better understand the scope of your network!

Plan limitations and exclusions

It’s important to know what your plan does not cover. Elective surgeries and alternative therapies are commonly excluded from most health care plans. Dental and vision services typically need to be purchased on separate insurance plans.

Health and wellness resources

Some plans offer rebates for various health clubs and facilities. It’s a perk, but if you’re deciding between two plans, it might make all the difference.

Choosing a health plan that works for you can seem like a daunting task, but don’t let all that healthcare jargon frighten you. As you weigh your options, please check out our informative webinar and our National Benefits Platform for more information.

Remember, we’re here for you. It’s time to find the coverage that works for you!

Freelancers Union Creating a better future for all independent workers across the United States.

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