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News~ How Much Health Insurance Should You Have?

2017-06-14 22:06 [INSURANCE] Source:Netword
Guide:To find a plan that’s ‘just right,’ do an examination of your needs and priorities.

How much health insurance do you need?

The short answer: enough to help you and your family weather an unexpected illness or injury and/or manage chronic health conditions without undue Financial hemorrhaging.

“You know you’ll likely need something, even if you’re a totally healthy person,” says Amy Bach, executive director of United Policyholders, a San Francisco-based insurance consumer advocacy group. “For most people, it’s about comparing deductibles, copays, benefit limits and reimbursement rates — basically, everything that you could be responsible for — and then any portion of services that would fall to you, such as hospital stays.”

Not much freedom of choice

Unlike home or auto insurance, there’s no way to place a value on the asset being insured — in this case, your health and the health of your family. And because the worst-case cost of medical remediation can be astronomical, insurers tend to hedge their risk and keep coverage affordable by offering their densely detailed cost-sharing contracts with little or no customization. So, often the question isn’t really, “How much health insurance do I need?” but, “What health insurance can I get?”

Health insurance is offered much more on a take-it-or-leave-it basis,” says Bach. “About the only thing you get to choose is how many people you put on your plan.”

Typically, the employer-sponsored group plans that cover most Americans cost consumers less than individual insurance policies because the employer pays part or all of the premium.

The downside is, employers tend to offer only a limited number of plans, often one each from a health maintenance organization (HMO), a preferred provider organization (PPO) and/or an exclusive provider organization (EPO). Choosing from such a small slate of group plans may sound simple, but there can be challenges.

“You don’t want to sign up and find that the doctor you really like and have been going to for 10 years isn’t in the plan you chose,” says Dr. Keith Davis of Shoshone, Idaho, named 2014 national Family Physician of the Year by the American Academy of Family Physicians. “That could steer your decision.”

Not ‘How much?’ but ‘Which plan?’

Like work-based health insurance, individual coverage that you buy directly from insurers on the private market also presents more of a question of “Which plan?” than “How much?” And, selecting the right individual market plan has not been easy.

“You couldn’t do an apples-to-apples plan comparison because the plans looked so completely different,” says Bach. “There was no way to categorize them.”

That challenge eased dramatically late last year with the opening of the state health exchanges, America’s first public health insurance marketplace, created by President Barack Obama’s landmark Affordable Care Act.

The one-stop, online marketplaces provide easy-to-browse summaries of every policy in your state that is exchange-approved to comply with the Affordable Care Act. For ease of shopping, the exchanges organize their plans into four metal categories: from the highest priced/lowest deductible platinum plans on down through gold and silver to the lowest priced/highest deductible bronze plans.

Jen Mishory, deputy director of Young Invincibles, an advocacy group for consumers aged 18 to 34 years old, says the New federal minimum coverage requirements for exchange policies further simplify shopping for coverage.

“On the exchanges, you now have the 10 essential health benefits, so you know that you’re getting a plan that covers a lot of the services that young people need, such as free annual checkups, access to prescription drugs, and mental health and maternity services,” she says.

Get a health insurance quote.

Health insurance rules of thumb

Follow these steps to find the right health insurance plan for you:

Do a health inventory: How’s your overall health? How often do you visit the doctor? Is your lifestyle risky? “The same principles apply to buying health insurance that apply to any other kind of insurance, which is: Try to know your risk,” says Amy Bach. 

Measure your health care consumption: How many times did you visit the doctor last year? The year before? “If you went an average of 10 times a year, and your primary care copay was $20, that’s $200,” says Bach. “Now break out your copays for specialty/urgent care, lab tests, prescription drugs and so forth. That should give you the rough math of your health care consumption.”

Survey your options: If you have health insurance through work, understand your choices. Or, if you buy your own coverage or are currently uninsured, peruse your state exchange to become familiar with your plan options there. You may qualify for a tax credit to help pay your exchange plan premium.


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