How To Choose The Right Health Insurance Policy

This article is an original article from January 5, 2009.  It was written by Nick Perry.

If you look around this website, you’ll find pages and pages of information about how wonderful it is to use an independent agent, how having an expert on your side can save you time and money when dealing with health insurance companies, and how having your own, personal agent on call to address your insurance needs can truly save you. But, there is one downside to using an independent insurance agent: we’ve got access to hundreds of different policies.

Now usually that’s a good thing. It means that you have a great deal of choice, that you’re not tied down to any one company or product line, and that your agent can just about always find a policy that offers the right combination of protection and monthly cost for your needs. However, that amount of choice can also get a little overwhelming and can make the task of narrowing things down to just one plan seem slightly daunting. Imagine walking onto the lot at a Carmax and just telling a salesman “I want a car.” He’d probably look at you blankly and have no idea where to get started, right? Even though that car salesman knows where everything is on the lot and knows the details and specs for all of his cars, he still needs you to let him know a little about what you want in order to help you find the right vehicle for you. So you go to the dealership armed with a little information, like how many passengers you want to be able to seat, what color you want, what kind of interior, and so on and so forth. Health insurance works in a very similar way – there are hundreds of plans out there, and the benefits are very different with all of them. Some cover well-care for children, while some have excellent accident benefits. Some have better copay structures, while some have an awesome health savings account component. If you know a little bit about what you want, you and your agent can work together much more effectively to find the policy that will work best for you.

So, how do you do that? How do you go about figuring out what type of policy is best for you and your family? You don’t have to have all of the answers, of course, since you’ll be working closely with an independent agent and he’ll be able to help you figure that out, but like we discussed a moment ago, it’s a good plan to have a basic idea of what your needs regarding health insurance will be.

In my experience, the best way to get started is to ask yourself three questions:

  • What do I like about your current policy?
  • What don’t I like about your current policy?
  • If I could design a policy from the ground up for yourself, what would you put in it?

Answering these three questions will just about always point you towards the right policy for you. There are a few things to keep in mind when you’re asking yourself these things.

When you’re thinking about what you like about your current health insurance plan, think about the past few times you’ve had to use it. Have you been to the doctor’s office or emergency room lately? Did you have a copay for either visit? Have you had to call your insurance company recently, and if so, were you satisfied with the level of customer service you received? What kind of deductible do you have now? How are your prescription drugs handled?

Thinking about these things will also probably reveal what you don’t like about your current plan. Maybe your current deductible is too high, or your prescriptions aren’t covered like you want them to be. Maybe you don’t have a copay and you want one – or maybe you do have a copay, but you never use it and want to lower your premiums by doing away with it.

When you get through thinking about what you like and don’t like about your current insurance policy, you should have a decent idea about how you feel about your deductible, your copay, and your premiums. Additionally, if you’ve had to use your health insurance lately, you’ll probably have an idea about any special circumstances you want your policy to cover (for instance, if chiropractic care is covered, if wellness benefits are included, and so on).

Now with that information, you’re ready to tackle the third question: if you could design a policy from the ground up, what would you put in it? This is where you get to make sure any special considerations you may have are taken care of. For example, do you want to make sure that your child under age five will have free well-care checkups? Do you want to make sure a certain prescription drug is covered? Do you want to have extra coverage if you have some kind of accident (known as a supplemental accident benefit)?

The next step is to take this idealized plan you’ve built and give it an unfortunate “reality check.” Personally, I want a health insurance plan that has a $10/year deductible, covers all of my office visits with a $2 copay, gives me free prescription drugs whenever they’re prescribed, sends me Chinese food on Fridays, and does it all for under $5 a month. That plan, however, doesn’t exist, which means you’ll need to identify which category you have more flexibility in: are you more willing to let your premiums go up a little to get the coverage you want, or do you want to increase your deductible and maybe eliminate your copay to get down to the monthly premiums you can afford?

Think about this: the difference between a $1500 and a $2500 deductible is $1000 a year, but if you save $84 a month by moving to a higher deductible, then you’ll have made up that difference just from your premium savings. That means you have that money in your pocket instead of sending it to the insurance company – and believe me, if you don’t meet that $1500 deductible, they’re not going to send any of your money back for “overpaying” them. Raising your deductible can put extra money in your pocket while still giving you comprehensive coverage, and is probably the area you should look at when you’re trying to figure out how to fit health insurance into your monthly budget.

Now, you’ve identified what you like about your current policy, what you don’t, and what you would change. On top of that, you’ve figured out what sort of deductible you’d like to look at, if you want an office visit copay, and any special things you want included in your new health insurance policy. Furthermore, you’ve figured where you can be flexible if you have to be: benefits, or premiums. The only thing that’s left is to sit down and start looking at policies until you find one that matches what you want.

Everything up to now has sounded harder than it really is. Unfortunately, this last part flips that on its head by sounding significantly easier than it is. There’s much more to the final step than writing down a deductible, copay, and premium amount and just looking at plans until one matches up. This is where your independent agent comes in. With access to hundreds of different policies, that choice that earlier looked overwhelming now just looks welcoming.

With the knowledge you’ve gained from reading and applying the techniques outlined in this article, you and your independent agent are now ready to sit down and figure out the exact policy that will work best for you. And remember, working with your independent agent to select your personal health insurance policy isn’t just a one-time interaction – you’ll be getting an expert on your side who will work for you for the life of your policy. But you’ve already read the article about Why You Should Use an Independent Agent, right?

If you have any questions about how to figure out what’s most important for your needs when it comes to health insurance, please don’t hesitate to contact me! You can always use the contact link located at the top of every page on this website, or call me direct at 888-441-7891 extension 707. I’m always thrilled to help a new client figure out what coverage is right for them!

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