When choosing a health plan for you and your family there’s some critical things that are often overlooked in lieu of the monthly premium.  A little thought and consideration, and help from a professional can make an enormous difference at the time of service and in your potential for surprise bills.  Here’s a few things to think about before you pull the trigger and then suffer unnecessarily for the following twelve months

  1. Where’s the RISK

Unfortunately, this is a reality; and something often overlooked when choosing a health plan.  There’s two ways you can plan to spend your money every year: on a high premium or at the time of service.  The majority of people we meet with tell us they’d rather have a small monthly premium and risk more out of pocket when or if something happens.  This is human nature, we can compute a monthly cost to our budget and hope “nothing happens,” however, when it does, the money owed to a doctor or hospital can take a major dent out of savings or be an additional monthly expense.  If it’s possible, try to find a blend of monthly premium and potential out of pocket costs that you can handle by asking yourself a few questions: 1. Can my family absorb a several thousand dollar hit if something happens, if so, how much?  2. Where’s that money going to come from, savings, retirement, a supplemental plan?  As healthcare costs are going back to the patient rather than the carrier, it’s more important than ever to have a clear understanding of what that means, in real dollars, to you and your family. 

2.    Is My Doctor Covered?

Seems obvious, right? Wrong. Most people buy on price without asking this question. A doctor can become a confidant and in some ways a friend; it certainly takes a good deal of time to build trust and rapport with one.  Make sure you’re aware of your connection with this person and decide, prior to a health plan purchase, if your relationship with him or her is worth considering in your decision.  If so, be sure to understand with which carrier’s that doctor has contracts so you can choose a plan accordingly.  Word of caution: just because a doctor says they take a carrier, doesn’t mean they’ll take your plan.  Every carrier has multiple plans and tiers of plans, generally the doc will operate within a tier, or several tiers, this warrants double checking so you don’t face an unnecessary surprise.

3. Which Hospitals?

I know, we’re all bulletproof.  In our experience only about twenty percent of our clients consider this.  Several years ago, my husband and I returned home from a trip to DisneyWorld.  On the plane ride home he started to have a little pain in his back and within an hour of getting home he was writhing on the floor.  This called for an ER trip.  Side note, did you know rollercoasters can shake loose kidney stones? In the moment, when my husband is dying, do you think I tried to make the decision about which hospital to go to? Nope.  I already knew.  Don’t make the decision in the heat of the moment, know BEFORE you need it.  On our trip to the ER we passed two other hospitals to get to the one that was in our network. I recognize that a decision like this will sometimes be out of your control; taking control and making the “right” choice saved us more than five thousand dollars in out of network charges. 

Take the time to think about these things, in reality you probably answered the questions for yourself as you read this.  Apply those answers to your decision for the coming year’s enrollment.  The complexity of this market, and Health Care in general, requires some care beforehand.  You know what they say, “an ounce of preparation is worth a pound of regret;” in this case that regret could cost you thousands, so give the ounce your time.