Hi, This is Brian Bale. Thanks for requesting my free report. Shopping for the best health plan can be confusing and frustrating. Here are some important tips that can help you to avoid the most common mistakes that people make when choosing a health insurance policy:

1.) Verify that your plan network allows you to choose your own doctors and hospitals.

Your health insurance policy is only as good as your ability to use your plan! There are many types of health plan networks…PPO, HMO, EPO, etc… and the rules are different for each type of policy. Most HMO and EPO plans typically have limited networks of providers and do not pay any benefits to out-of-network doctors and facilities, except in emergency cases. Also, these plans typically require you to get a referral from your assigned primary care physician to see a specialist. PPO health plans, on the other hand, allow you to choose your own providers and typically pay benefits even to out-of-network providers. So if you want to keep your existing doctor or go to the hospital of your choice, PPO plans are usually the best choice. Best of all, the cost of a PPO plan is rarely more than the cost of and more restrictive HMO or EPO health plan.

2.) Ask if pre-existing conditions are covered under your policy.

Health plans offered by employer groups or ACA (Affordable care Act compliant) Obamacare plans are required to cover pre-existing health conditions without any waiting period for benefits. This is the primary reason that these plans are so costly and have very limited networks of providers. These types of policies are normally the best fit for individuals with expensive, chronic, ongoing health conditions because despite the high premiums, coverage is offered immediately for pre-existing health conditions. Note: Obamacare policies are normally only available during the annual open enrollment period unless a person has experienced a qualifying life event, so they are not always a plan option that is available.

For people who are in reasonably good health, policies that have a waiting period (typically 12 months) for full coverage of pre-existing health conditions can cost up to 50% less than plans that must cover pre-existing health conditions without a waiting period. So if a person sees a physician twice a year for treatment of high blood pressure, the monthly premium savings for a policy with a pre-ex waiting period would far outweigh the small out-of-pocket costs for two office visits that would not be covered in year one of the policy.

Total healthcare costs are a combination of monthly insurance premiums AND out-of-pocket costs that an individual pays for healthcare-related expenses not covered under his ior her health plan. So a more costly health insurance plan may not save you money if it doesn’t help to reduce your out-of-pocket healthcare costs.

3.) Make sure your policy has adequate coverage for major surgeries and hospitalization.

Nearly all health insurance policies pay benefits for hospitalization and surgeries. Some policies have waiting periods for benefits or exclude coverage for specific conditions. So be sure to read your policy carefully to know what is not covered.

Also, many polices have limits on the maximum benefits that are payable per medical claim or per policy term. Another way that insurance carriers limit coverage is how much of the bill the insured has to pay in the form of deductibles and coinsurance. Be sure to ask about the features of your policy before enrolling in a health plan.

Most polices do not pay benefits for cosmetic or “elective” surgeries that are not medically necessary to treat an illness or accidental injury. Also, many health policies do not pay benefits for medical treatment outside of the United States. Quality health plans should always have benefit provisions for paying the hospital, surgeon, anesthesiologist, etc… so be sure to ask about how your policy covers surgery and hospitalization.

4.) Ask about any policy limitations and exclusions.

Many policies outside of employer group plans and ACA Obamacare plans are legally allowed to limit coverage offered in a health insurance policy. These policies are less costly but do have some coverage limitations. One example of coverage limitations that makes sense would be a plan that does not pay benefits if a person is using illegal drugs which cause an accidental injury or sickness. Other plan limitations that may not make sense would be plans that do not cover childbirth or do not cover a gall bladder attack for the first 6 months of the policy.

It is always a good practice to read the back pages of your policy to find out about coverage limitations and exclusions. Smart consumers will always utilize the free services of an experienced health insurance agent or broker to assist in the process of identify the weak points of any health plan.

5.) Verify the rating and reputation of the insurance carrier

There are hundreds of different health insurance carriers across the nation. Some are better than others in terms of plan benefits, customer service and claims payments. Be sure to check out any carrier you are considering online before you buy a health policy. A reputable carrier should have a public website and good overall customer reviews and BBB ratings. There are rating systems like AM Best that rate carriers on the basis of their financial strength and stability that you may also want to research to make sure you’re dealing with a good insurance company.

6.) Make sure you’re not paying for benefits that you do not want or need.

Would a 60 year old woman need a health plan that costs more because it includes maternity benefits? Obviously not! Some health plans force people to pay for extra benefits, like maternity care that they may not ever use. Some add-ons that you may not want can include thing like life insurance, group association benefits, dental, vision or hearing benefits. The ACA (Affordable care Act) health plans have many mandated benefits that must be included in policies. This results in significantly higher monthly premiums. Be sure to ask for non-Obamacare health plan quotes from your insurance carrier, agent or broker to avoid paying for benefits that you may not need in a health policy.

Conclusion: I hope that you found this information to be useful in your search for the best possible health insurance plan. It is always wise to work with an experienced health insurance broker to help to guide you through the process of finding the best policy. There is no cost for the services that I provide to help you to locate a quality health plan. Call me anytime at 469-455-9100. I work with all the major insurance carriers and I’m always available to answer any of your health insurance questions.

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