Health insurance is a big ball of wax — so big, in fact, that many of us put it on the back burner rather than deal with it. But it’s one of the most important decisions we have to make as consumers. Not only does it determine the care that we receive should our health take a wrong turn, but it can be the wild card in your financial plan. Roughly half of all bankruptcies filed in the United States are caused by illness and medical bills.
Whether our next president will be able to wrangle our healthcare system remains to be seen. Until then, choosing the right healthcare plan remains one of your most important decisions — not just for those people who are selecting from an employer’s benefits menu, but for those 46.6 million uninsured Americans who are trying to put at least some coverage in place.
Here’s how to whittle down the choices and keep costs for premiums, co-pays and prescriptions from draining your bank account:
Insurance plans and prices vary widely by state. New York, for example, has some of the most expensive individual plans in the country, largely due to its guaranteed-issue policy that requires companies to insure everyone, regardless of health.
The best way to kick off your shopping is by doing a little research on your state’s insurance Web site, says Kimberly Lankford, author of “The Insurance Maze: How You Can Save Money on Insurance and Still Get the Coverage You Need” (Kaplan Business, 2006). A good site will list companies available in your area, prices for both individual and family plans, and any lower-cost options your state offers if you meet certain income requirements.
Write out your priorities
Do you love your current doctors? Then you should choose an insurance company that covers their service. “It’s so important that you make a list of the top five things important to you, and bring them up to the broker or insurance company,” advised Michelle Katz, a healthcare consultant and author of “101 Health Insurance Tips” (LifeTips.com, Inc., 2007). This way you can really start to narrow things down by your needs, whether that means low premiums, customer service or the doctor you’ve been seeing since college.
Don’t be afraid to use a broker
An insurance broker can be a huge help. He can do the legwork to find a well-suited insurance company, help shop for the best rates, and explain the ins and outs of your plan. To find a reputable broker, check credentials with either the National Association of Insurance Underwriters (nahu.org) or the National Association of Insurance Commissioners (naic.org). You also want to make sure he has a large “book,” the industry term for the network of providers he works with. More options mean a better deal and a better fit.
Ask for a “free look”
Lots of things come with a trial period — your gym membership, magazine subscription and virtually anything hawked on an infomercial — but did you know that you can sometimes test-drive your insurance plan? They call this a free look, and it basically means that you can get your money back if you’re unsatisfied within a set period of time, explained Katz. The key here, though, is staying on top of things and making sure you follow the guidelines. Restrictions vary by company and plan, but you could have anywhere from one to six weeks to ask for a refund — probably in writing.
Consider a Health Savings Account
An HSA is a great option for people who generally only have to whip out their insurance card once or twice a year. Maybe you go for a yearly checkup, and then to the doctor if you have the flu. It goes hand-in-hand with an insurance policy that has a high deductible ($1,100 for individuals; $2,200 for families), but low premiums. The money you save on premiums each month can be deposited into the HSA pre-tax, where it grows tax-deferred. You then use it to pay for any unexpected medical expenses. The bonus? Once you turn 65, you can withdraw any money you didn’t use and spend it on anything you want, including funding your retirement.
You’ve chosen a plan, but you’re still not home free. Bills can pop up everywhere, from services that aren’t covered to doctor and hospital co-pays to costs for prescriptions. Many insurers have instituted a system of preferred pricing when it comes to prescriptions, meaning that if yours isn’t generic and on a list, it could still cost a bundle.
“Now, even people with employer coverage are having to be smart shoppers for prescription drugs, especially if they have a regular medication that is pretty expensive,” said Lankford. Keep your costs low by shopping around (prices can vary among pharmacies — your best bet is a discount store or price club) and asking for generics whenever available. You can also have your doctor write out a prescription for a longer period of time, so you’ll get a 90-day supply instead of a 30, advised Katz.
The co-pay will be the same. And don’t be afraid to negotiate with your doctor if you’re paying out of pocket. In a recent Harris Interactive poll, three out of five people who did so received a discount. With the cost of a single visit often tallying over $200, it’s definitely worth a try.