Choosing Health Insurance

How to Choose a Health Insurance Plan

It’s time to shop for a health insurance plan. Oh boy.

We get it. Choosing one can be really confusing — there are, like, a gazillion options out there. And with lots of complicated terms, it’s sometimes hard to feel confident you’re choosing the right one.

So, here’s the good news — there are three main things to consider when you’re selecting a health plan: your plan type, plan level and medication needs.

You’ll likely be considering which plan is right for you during open enrollment, when you can shop for a plan on the Health Insurance Marketplace. For tips on comparing plans and choosing the one that’s best for you, call us at 855-219-4662 we can help you navigate.

Choose how you want to work with a doctor

Some plans require that you choose a primary care provider (PCP) to manage your health care. Your primary care provider manages your health and refers you to a specialist, if needed. In some plans, you can see any network provider.

Check the plan network

All plans cover visits to network doctors, clinics and hospitals. No matter which plan you choose, you’ll always save money when you see a network provider. To find doctors, clinics and hospitals in the network for Marketplace health plans, check the provider directory.

Decide which level of coverage you need

Health insurance plans are organized into 4 metallic levels, based on how you and the plan will share costs. The plans in all 4 categories offer the same essential health benefits. The difference is in how much help you want paying for things like hospital visits or prescription medications. For example, bronze plans may have lower premium costs, but you may pay more for health services.

Bronze Silver Gold Platinum
Your Monthly Premium $ $$ $$$ $$$$
Your cost per visit / drug $$$$ $$$ $$ $
Consider this plan category if: You rarely see a doctor, and you are willing to pay a higher co-pay when you do. You want to balance monthly premium, co-pay and deductible costs. There are several choices in between the bronze and platinum plans. You see doctors more often and are willing to pay higher monthly premiums to lower your  co-pay

Check prescription drug coverage and costs

Each health insurance plan has a Prescription Drug List of covered medications. The drugs are grouped into cost levels, called tiers. The drug tier indicates the amount you pay for a prescription, as determined by your benefit plan. You’ll save money by using medications in tier one (lowest cost). To see if your medications are covered in the Marketplace health plans, check the Prescription Drug List for commonly prescribed medications that are covered.

Exclusions and limitations

Make sure you’re aware of what might not be covered. Common exclusions and limitations include elective or cosmetic surgery and alternative therapies. While some plans cover pediatric dental and vision services, dental and vision plans for adults may need to be purchased as they are separate plans.

Call us, we can help or request a quote


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