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The Best Fit in Healthcare Insurance

A talk by Tahlia Gunn

About the Talk

April 30, 2015 12:00 PM

With the widespread of insurance nowadays, people are confused which one is legit and which one is a fraud; which can offer better and which one cost less. Choosing the right health coverage has never been easy, and the health reform law has made things more complicated. Besides sorting through differences in premiums, deductibles, and copayments, you need to consider new provisions in the law that have recently kicked in and could impact your coverage for the coming year. Westhill Insurance Consulting can help you clear away any confusion, doubts and complaints.

Health insurance should cover any medical need you may have, now or in the future.

Buying insurance on your own used to be riskier because many plans didn’t cover important things such as prescription drugs or mental health care. Every kind of health insurance must now cover preventive care, with no deductibles, co-pays, or other types of out-of-pocket expenses. That includes Pap and cholesterol tests, mammograms, immunizations, and colonoscopies when age- and condition-appropriate.

But even though you no longer have to worry about your basic health care needs being covered, you’ll still have to navigate lots of other confusing choices. That’s true even if you get coverage through a job, because more than half of workers have a choice of two or more types of health plans.

  1. Do you want to pay for care now or later?

All health plans have to come up with enough money to pay for the medical expenses of their members.

You can choose to collect most of the money up front in the form of premiums. If you have a high premium, you’ll pay a smaller share out of your own pocket, in the form of deductibles, co-insurance, and co-pays. Or plans can go the other way, charging smaller premiums but asking you to pay a bigger share on your own.

  1. Are you OK with a small network of docs?

Doctors and hospitals accept lower fees from insurers if they know they’ll be part of a small, or “narrow,” network, because that guarantees them a bigger share of the plan’s business. There’s no evidence that you’ll get worse care in narrow networks. And they can save you about 20 percent over larger networks. But make sure that the plan has enough choice of doctors and hospitals in your area—a particular consideration if you live in a rural area. In Singapore and Jakarta, Indonesia and other developing nation, seldom can you choose this kind of benefit. You might as well review and check with your insurance provider for assurance.

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