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  • Seven Common Health Insurance Mistakes

    When selecting a health insurance policy, evaluate what you need as well as how much risk you can afford to take. Keep your eyes open for potentially nasty surprises.  Poring over the fine print of health insurance plans to choose a policy is at best, tedious, but you’re better off researching  before you buy than risk being under or over insured later. The right fit will depend on your needs and how much financial risk you can bear. 

     Whether you’re choosing among group health plans offered by your employer or shopping for individual health insurance coverage, there are seven mistakes to avoid.

     1. Your doctor isn’t in the network. You’ll pay more to use health care providers who aren’t in your health plan’s network, so check to see if the doctors and other professionals you want are included. A plan that tightly restricts you to a local network might be sufficient if you need care only in your area, but it won’t benefit a kid away at college or meet all your needs if you spend a lot of time on the road.  Make sure any specialists you need are also covered by the plan.  Don’t assume a specialist is in the network just because your primary care doctor gave you the name.

     2. You pay huge insurance premiums to save a few bucks on the co-pay.  Don’t focus so much on getting a low co-pay and fail to look at how much extra premium you will pay for it.  Evalute the need for the extra premium cost.  If you go to the doctor only a couple of times a year, is it worth hundreds of dollars extra on the premium just to get a lower co-pay?

    3. The drugs you take aren’t covered.  If the plan provides prescription-drug coverage, check to see if your medications are included on its formulary, which lists the preferred drugs that are either included or covered at a better copay.  Check to see if  the plan provides discounts if you mail-order prescription drugs in bulk.

    4. You are overinsured.  In addition to comprehensive health plans, many employers offer supplemental insurance policies, such as cancer or critical illness insurance, that pay a lump sum of cash after diagnosis. Such policies can provide valuable protection, but they might not be unnecessary if you already have excellent under your medical insurance and short-term and long-term disability insurance plans. 

    5. You can’t afford your share of the medical bills.  Low premiums are an attractive feature of high-deductible health plans, however, you need to make sure you’re prepared to pay your portion of the medical expenses.  Check the maximum out-of-pocket expenses you pay. After you pay the deductible, many plans pay only a portion, such as 70%, of covered medical expenses. Your 30% share is called co-insurance, which you must pay over until you reach the cap on out-of-pocket expenses.

    6. Your policy doesn’t cover maternity care.  Most employer-sponsored plans cover maternity and prenatal care, thanks to federal and state laws in place.  Individual plans do not require maternity coverage.  Starting in 2014, individual and small-group plans sold through state health insurance exchanges must include pregnancy and newborn care, along with other essential benefits.

     7. You don’t check your health plan for changes.  During your annual open enrollment, check the details of your current health plan to be aware of any changes that may impact your health care needs. Don’t assume the plan is still the same. Coverage levels, costs and networks could change from one year to the next, even if the plan is offered by the same insurer.

    A good Health Insurance Advisor or Broker will help you sort through the plans available and help you find the plan that best suits your needs.  Please call our office at (888) 474-6627 and we will be happy to help you find the right plan for you and your family.

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