Choosing health insurance that meets your needs

2012-12-27T00:00:00Z Choosing health insurance that meets your needsFamily Features nwitimes.com
December 27, 2012 12:00 am  • 

Millions of working Americans are still without health insurance, and many more worry about whether they'll be able to afford their existing coverage due to rising health costs.

"With the rising cost of care, individuals want more affordable options when it comes to health insurance," says Scott Krienke, senior vice president, marketing and product lines at Assurant Health. "Consumers want coverage tailored to their budget and how they manage their health. Before choosing a health insurance plan, it's important to understand all the options to find the best fit for your needs."

Whether you're looking for additional coverage to supplement your employer's plan, or want an individual plan because you're self-employed or uninsured, here are a few tips to get you started.

Major Medical

Under the Affordable Care Act, major medical plans now cover 100 percent of many preventive services. Many people are familiar with major medical insurance, which can be offered by employers and which is usually most comprehensive in covering serious illness or injuries. Major medical plans generally offer the broadest protection and protect against large, unexpected medical expenses.

Fixed-Benefit Plans

In general, fixed-benefit plans pay a set amount of money when you have a covered medical service, regardless of the actual cost. For example, if the plan pays $50 when you have an X-ray, but it costs $125, after applying the plan payment of $50, you would owe $75.

Unlike a traditional plan that has deductibles, coinsurance and copays, fixed-benefit plans pay a benefit for covered services immediately. Some provide access to network discounts that can significantly decrease the total cost of care. These plans can cover a range of services from everyday office visits, preventive care and prescriptions, to hospitalization and surgery. Check to see if there are pre-existing condition limitations for the first 12 months of coverage.

Fixed-benefit plans can offer significant coverage. For example, hospitalization reimbursement can be as much as $6,000 per day depending on the plan. Some even offer tools to help manage costs, like guaranteed cost estimates for common services and treatments.

Analyzing Your Insurance Needs

How do you decide what type of plan is right for you? It depends on your needs, what's most important to you, and sometimes the tradeoffs you are willing to make to get the coverage you want at an affordable price. Here is information on those types of plans to help in your decision-making:

Supplemental Insurance Plans

Once a decision is made to purchase a major medical plan or fixed-benefit product, supplemental plans can be used to fill gaps in coverage and create additional protection. Supplemental insurance, which can be offered through the workplace or sold individually, offers limited coverage for specific health care needs such as in-hospital care, dental checkups or vision.

"Do your homework, and weigh your options - there are affordable plans that can fit into your budget and give you the coverage you need to help protect yourself and your family," said Tim Knott, senior vice president of strategic markets and product management for Assurant Employee Benefits. "Supplemental insurance provides a wide array of benefits that can help employees cope with out-of-pocket expenses including those associated with serious accidents or illnesses."

Learn more about choosing health and supplemental insurance plans at www.assuranthealth.com and www.assurantemployeebenefits.com.

Comparing health and supplementary insurance coverage

To do a comparison of costs and coverage with any plans you're considering, it's wise to look at:

-Premiums, which are the amount paid each month for your plan.

-Coverage/benefits.

-Access to doctors, hospitals and other providers.

-After-hours access and emergency care.

-Out-of-pocket costs.

-Exclusions and limitations.

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