How to Choose the Right Medical Insurance Plan

A medical insurance plan covers some or all of a policy-holder’s health care expenses. In exchange for a monthly premium (the amount you pay to have the plan) and copays or coinsurance (your portion of the cost), medical insurance helps pay for certain covered services and medical costs like prescription drugs and hospitalizations.

The type of plan you choose depends on your budget and your preferences. You’ll want to consider factors like your preferred network, deductible, coinsurance and out-of-pocket maximums. You’ll also want to consider whether you have any pre-existing conditions or any other specific needs you’d like to address with your coverage.

To help you narrow down your options, start by identifying the doctors and hospitals that are part of each health insurance plan’s network. In general, medical insurance companies negotiate lower rates with networks of providers, so choosing a provider that’s in the network can save you money. In some cases, you may be able to find out whether your doctor is in the network by checking with them or by looking at the plan’s provider directories.

Once you’ve determined which providers are in the network, it’s time to review plans. Look at the monthly premium, deductible and coinsurance to get an idea of what each plan might cost. In addition, you’ll want to check that the plans you are considering cover your preferred medications. You’ll also want to consider whether the plan offers a 24/7 nurse line or any other extra benefits, such as discounts on wellness programs.

Lastly, you’ll want to make sure that any plan you are considering has a large enough network to give you the coverage you need. You can do this by searching for the name of your doctors or the specialty you are seeking in the plan’s provider directory. Eliminate any plans that don’t have a large network, or that are limited to your city or state, if possible.

Bronze Plans

Bronze plans tend to have the lowest monthly premiums but also have the highest out-of-pocket costs. These plans are best for people who know they will use a lot of healthcare and have the savings to pay for their portion of the costs until they meet the deductible. Some of these plans provide free preventive care and select services before the deductible is met.

Silver Plans

A middle ground, Silver plans have higher monthly premiums than Bronze plans but lower out-of-pocket costs. These are a good choice for people who need a little more coverage than Bronze but don’t require the extra protection of Gold or Platinum plans. In addition, some Silver plans offer cost-sharing reduction subsidies to people with incomes below $36,000 as individuals.

Platinum Plans