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How do you shop for health insurance?


Comparing Health Insurance Plans
If you want to see a certain doctor, be sure he or she is part of the insurer's network of providers.
If you want to see a certain doctor, be sure he or she is part of the insurer's network of providers.
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On the last page, we talked about making a wish list of the health insurance benefits that you'd like to have in an insurance plan. With this list in hand, we can check which of the plans in HealthCare.gov's database fits these needs. HealthCare.gov provides links to each insurer's Web site, where you can find the list of benefits and services covered by a given plan. If you put your wish list items on separate lines down a piece of paper, you can then put the plans that you're investigating across the top -- voila! Instant comparison check list. Making charts and keeping detailed notes -- whatever methods that make it easy to evaluate the various plans -- may seem tedious, but it will save you time in the long run.

As you compare the coverage offered by different plans, you'll probably be able to eliminate the ones that aren't right for you. Perhaps your favorite doctor isn't in one company's network of preferred providers, while a single male may be able to eliminate options that offer extensive maternity care he doesn't need. It's also important to consider any caps on coverage, such as the number of appointments or medical procedures you can have.

Now, the element you've been dreading -- price. Eventually, HealthCare.gov will feature pricing information, but for now you can find pricing on a company's Web site or call them to obtain a quote. There are a few numbers to consider. First, there's the premium, or the fee that you pay for coverage. Once you've secured coverage, there are a few more costs you'll have to absorb out-of-pocket before the insurance company picks up the tab. For example, a visit to a doctor's office for a check-up may require a co-pay, such as $20, while other plans use a coinsurance method. That same visit may be split 80/20 between the insurance company and the patient, so that you'd pay 20 percent out of pocket to see the doctor. Take note on how these fees increase if you need care outside your service area; out-of-network fees are usually tremendously high and should be avoided if possible.

Lastly, you'll also carry a deductible, which is the amount of money you have to pay for service before your insurer will pick up the rest. Deductibles can range from a few hundred to a few thousand dollars. The higher your deductible, the lower your premium, but selecting a very high deductible is a bit of a gamble. After all, you could get into a car accident tomorrow and be on the hook for several thousand dollars before your insurance company pays a dime. For that reason, you don't want to select a deductible that's more than you can pay out. You should also check that a plan has an annual out-of-pocket limit; a cap on these out-of-pocket costs will be vital should you get very ill or injured.

Ultimately, we can't tell you what you should pay, because that depends on your budget, but your completed checklist should provide a good guide of what you'll get for the money that you'd be paying.


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