Wondering how to pick the best health insurance plan, how to compare health insurance plans, and what to know before choosing health insurance plans? We understand it can seem confusing and difficult.
That’s why we’ve created a list of things to consider when choosing a health insurance plan. These questions and tips can help you sort through different health insurance marketplace plan details to find the best health insurance plan for you, your family, your health, and your budget.
With this information in hand, you’ll be ready to compare health plans with confidence and get closer to finding an option that checks all your boxes. Whether you’re picking a plan for the first time – or thinking about changing health insurance plans – the following sections have good questions to ask yourself when searching for the best health insurance for you and your family.
Choosing Health Insurance That Saves Money When Healthy
How to compare health insurance plans that meet your needs? Let’s do a little thought experiment:
Imagine that, under the health insurance plans you’re considering, you and your family have a good health year: You go to the doctor a few times for checkups, your partner only takes a couple of prescriptions, the kids visit urgent care a couple of times – and that’s about it.
If you don’t expect to use your plan that often (like in the scenario listed above), pay close attention to recurring costs to see if there’s an opportunity to save money. But remember: It’s impossible to fully plan for the unexpected, so be sure to also factor in the cost of getting care if (and when) you need it.
So…how to pick the best health insurance plan?
Here are a few questions to ask yourself as you compare plans:
- How much will I pay each month for health insurance coverage (monthly premium)?
- How much will I pay to see my doctor, visit urgent care, go to the emergency room or fill prescriptions (copays)?
- If I get the same care as last year, what would it cost under the plans I’m considering?
- Does the estimated sum of all these costs fit my budget?
There are 123 total plans available for 2022. See the 2022 Kansas Insurance Plans Brief (PDF).
Affordable Health Insurance When Sick
Now imagine the opposite scenario, where you use your health insurance plan a lot: You come down with an infection and need to stay in the hospital for a few days, your partner’s prescription list grows, the kids break a few bones at practice on top of getting strep in the fall – and more.
It’s always hard to see situations like this coming, so it’s wise to be sure that your plan makes care affordable if you need to use it. In the end, you’ll want to aim for a good balance between expenses you can plan for (like monthly premiums, deductibles, and the out-of-pocket maximum) and ones you can’t (like copays or coinsurance you pay only when you need care).
Now ask yourself these questions:
- How much will I have to pay before the plan starts to help (deductible)?
- What’s my share of the cost of other care, like getting an X-ray or staying in the hospital (coinsurance)?
- What’s the most I’d have to pay for care next year (out-of-pocket maximum)?
- Could I afford the out-of-pocket maximum if I had to pay it?
Check out the article “Using the Healthcare Marketplace and Saving Money on Insurance” for more information and tips on saving money.
Are Your Doctors in Network Health Insurance Coverage?
Health insurance companies work with different doctors and clinics to help you get the best deals on your care. Getting care from a person or place your plan covers saves you money. On the other hand, getting care somewhere else may mean your health plan pays less, leaving you with bigger bills. That’s why you’ll want to check that the doctors and clinics you expect to visit will be covered by the health insurance plan you’re considering by checking their network coverage.
Questions to ask yourself:
- How big is the plan’s coverage network? What kind of network is it?
- Is my current doctor covered by this plan (are they in-network)?
- How much will I pay if I see a doctor who isn’t covered by this plan (out-of-network)?
- Do I plan to get out-of-network care? Am I willing to switch doctors or locations if the ones I want aren’t in-network?
What is the Coverage for Prescription Drugs?
According to Georgetown University, two-thirds of all adults in the United States use prescription drugs, so there’s a fair chance you will, too (if you’re not already).
It’s not unusual for people to get so focused on the medical details of their health insurance plan they forget to look at the prescription drug coverage. These costs can add up, so be sure to review the plan’s formulary (drug list).
The formulary will tell you which drugs are covered and how much they’ll cost. That way, you can better plan your budget for any current drugs you’re taking (and any future ones you might need, like antibiotics).
Related questions to ask:
- How much will I pay for my regular prescriptions? Are they affordable?
- Do I need my health plan’s approval for any prescriptions before I fill them?
- Which pharmacies are in-network? Are their hours and locations convenient?
- What are my options if my prescriptions aren’t covered?
Alternative Therapy Health Coverage
Do you or a member of your family see a chiropractor? Planning to have your baby at home? Curious about acupuncture?
Different health plans treat alternative therapies (alternative medicine) in different ways. In some cases, you’ll be covered the same as any other care. In other cases, you’ll only be covered a little or not at all. If this kind of care matters to you, take a close look at your plan’s benefits.
Related questions to ask:
- How much do alternative therapies or services cost?
- Is there any kind of cost-sharing for alternative medicine?
- Do I plan on using alternative therapies often? Am I comfortable using other treatments instead?
Getting Help With Choosing Health Insurance Plans
In the end, health plans aren’t one-size-fits-all. You’ll want to talk to someone who can help match your unique needs with the plan that suits you best.
At Cover Kansas, we help people in Kansas find the right health insurance plan with the right coverage. We specialize in making things simple. And when things are simple, picking a health insurance plan feels less like being lost in the city and more like cruising down an open road.
Cover Kansas Navigators are trained, unbiased individuals that can help you compare health insurance plans, assist you with the online application process, and provide answers to your Marketplace questions year-round…for FREE!
Our free navigator services can help you:
- Navigate the Healthcare Marketplace
- Understand the Health Insurance Marketplace
- Compare Health Insurance Plans
- Pick the Best Health Insurance Plan For Your Needs
- Enroll in an Individual Health Insurance Plan
Call us toll-free today at 866-826-8375 or use our online “Find a Navigator” tool to schedule an appointment with a certified health care navigator in your area.