by: Dave Markel

Copyright 2005 Dave Markel

Choosing a health insurance plan that is best for you and your
family is one of the most important decisions you'll ever make.
Choosing between health plans is not as easy as it once was.
Although there is no one best plan, there are some plans that will
be better than others for you and your family's health needs. Plans
differ, both in how much you have to pay and how easy it is to get
the services you need. No plan will pay for all the costs associated
with your medical care, some plans will cover more than others.

Most Americans have health insurance through their employers, and
every year more employers offer insurance coverage by managed care
organizations (MCOs). Today, Americans are in an era of managed
care. It's a new experience for most people. Managed care companies
may decide what doctor you will see and when, and what treatments
will be covered. It requires you to make some important decisions
because not all managed care plans are the same.

In choosing a health insurance plan, you have to decide what is most
important to you. All plans have tradeoffs. It is worth asking
yourself a few questions such as:

• How comprehensive do you want coverage of health care services to
be? • How do you feel about limits on your choice of doctors or
hospitals? • How do you feel about a primary care doctor referring
you to specialists for additional care? • How convenient does your
care need to be? • How important is the cost of services? • How much
are you willing to spend on health insurance premiums and other
health care costs? • How do you feel about keeping receipts and
filing claims?

You might also want to think about whether the services that a
health insurance plan offers meet your needs. Call the plan for
details about coverage if you have questions. It is worth
considering the following:

• Life changes you may be thinking about, such as starting a family
or retiring. • Chronic health conditions or disabilities that you or
family members have. • If you or anyone in your family will need
care for the elderly. • Care for family members who travel a lot,
attend college, or spend time at two homes

Most health insurance plans provide basic medical coverage, but the
details are what count. The best plan for someone else may not be
the best plan for you. For each plan you are considering it pays off
to find out about a range of things from physical examinations and
health screenings, care by specialists and prescription drugs to
vision care and dental services. It is also important to find out
about the various offered services such as medical counseling as
well as what is on offer.

Ask if a certain service is limited or not covered. You should find
out if what is provided is what you require and if there are special
programs for certain types of illness. It is also worth finding out
about medicines and equipment that may be needed. Find out what
types of care or services the plan will not pay for. These are
usually called exclusions. Few indemnity and managed care plans
cover treatments that are experimental. Ask how the plan decides
what is or is not experimental. Find out what you can do if you
disagree with a plan's decision on medical care or coverage.

Finally you should think about the location of services and how far
you may be prepared to go for care. On this subject you should
consider whether or not the plan handles care when you are away from
home.

After you review what benefits are available and decide what is
important to you, you can compare plans. Many things should be
considered. These include services offered, choice of providers,
location, and costs. The quality of care is also a factor to think
about.


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