5 things to consider when choosing a health plan this fall

Co-insurance. High deductibles. Medical spending accounts. Choosing a health plan that’s right for you and your family can be confusing and frustrating. But it doesn’t have to be. Consider these five tips when choosing your health plan this fall.

1. Does the health plan have the doctors, hospitals, and specialists you use?

More and more health plans are limiting provider networks in order to keep costs low. If you want to stay with your current doctor or clinic, you’ll want to check out the provider networks for the plan you’re interested in to be sure you won’t be faced with out of network charges or higher co-pays.

 2Does anyone in your family have special health needs?

If you or someone in your family has ongoing health needs or chronic conditions, you’ll want to carefully consider your out of pocket maximums and deductible amounts. Your deductible is the amount you’ll pay before any of the plan coverage kicks in. With ongoing medical costs, you may want to consider a lower deductible, knowing you’ll likely reach it right away. But lower deductibles tend to go with higher out of pocket maximums, so you’ll continue to pay a co-insurance until you reach your out of pocket max. For younger, healthier individuals, a high deductible plan might not be a bad option to consider.

 3. Consider available health savings options

In order to help defray the cost of your deductible, consider participating in a medical spending or health savings account. These tax-advantaged accounts can be used to pay for your deductible, co-pays, prescriptions and a number of other costs. To help you determine how much to contribute to a medical spending or health savings account, take a look at your medical expenses for previous years and make an estimate of what you think you’ll spend next year. Are you planning an elective surgery? Will you or a spouse have a baby in the next year? Remember, you can only plan so much. The unexpected can always happen too so it’s nice to have some money set aside for the unanticipated broken arm or antibiotic.


 4. Look at the prescription benefit coverage

Don’t forget about this important detail. If you know you have certain medications you’ll be taking, be sure to check out the pharmacy coverage and know what your deductibles and co-pays will be. Also, be sure to use a pharmacy that’s in your network and try to go with generics whenever you can.

5. Notice any extra services the plan provides

Choosing a health plan with some enhanced benefits can go a long way towards helping you maintain a healthy lifestyle. Find out if the health plan offers any extra wellness services, a nurseline, or discounts on health club fees.  Then take advantage of these special programs or offers and work towards your own personal health improvement plan.

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