Does the health care insurance plan meet the minimum  standards?

Do you know what is covered?

How good is their network of hospitals?

How well is it priced?

Are you getting the best deductible?

You should know that your health care insurance company is in point of fact a medical insurance carrier and meets the minimum  standards for your state.  

Some carriers selling what appears to be health care insurance are selling discount plans.  These plans can lower your medical expenses in some scenarios, but do not provide substantial coverage.  They will often use names that are sound very similar to the names of well known medical insurance carriers.

The best way to make sure that you are dealing with an actual health care insurance carrier is to check with your state’s department of insurance.  They will have a list of approved health care insurance carriers.

You should understand what a given health care insurance company covers and does not cover.  

You should read the outline of coverage or brochure for any  medical care insurance policy you are considering.  There will be a section that mentions the “exclusions and limitations.”  Read this section carefully.  Most of the items in this section will be the same from contract to contract.  However, this won’t always be true.  Make sure that you are comfortable with the things the plan doesn’t cover.

You should understand how good their network is near your home.  

Is your doctor in the company’s network?  If not, are there other providers in the network who are close to your home or office?  Is your local hospital in their network?  Will you be able to get emergency coverage when you are on vacation in another state?

If you are a snow bird, it is important to know if you can get your routine care in taken care of in the area surrounding that other location.  Most plans will cover emergency care well whether or not you use network providers.  However, many will not cover routine care well if at all if the services are performed outside of the network.

You should know if a plan is well priced.  Make sure that it is competitively priced when compared to other similar plans from other health insurance companies.  You may be surprised to know how much of a price variance there is between similar health insurance policies.

You should know if a contract is priced well when the deductible and other cost shares are concerned.

This involves doing a little math.  When comparing two similar contracts with different deductibles, be sure to annualize the deductible and the premiums when judging health insurance policies.  Often when we do this we are able to pick out bargains.  Although it is true that when you pay more for a plan you can expect to have a lower deductible and vice versa, you may find that the premium drops faster than the deductible rises.  

Look at your net medical expenses in different scenarios.  This will help you determine whether a company is charging too much for a low deductible policy.  Calculate your total costs for your health care expenses when you include not just your annualized premium and your annualized deductible and other cost shares.  You will probably find that a medium or even a high deductible plan will be your best option.

The more knowledge you have, the better choices you will make regarding your healthcare insurance policy.  Knowing whether or not a contract meets your state’s minimum  standards, knowing the limitations of the contract, making sure that the network is adequate and being able to compare prices and deductibles are all important when it comes to finding the best  medical care insurance policy for your family.

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