Getting Prescription Meds: Everything You Need to Know About Choosing a Health Insurance Plan

Health insurance can seem complicated. It can sometimes feel like you have no idea which plans to choose or what you'll get with each plan. When you have medical needs, you need to know you're choosing the right health insurance plan so you can get your prescription medications and visit your doctors without spending all your savings. Here's everything you need to know to choose the right health insurance plan for you. 

Decide Which Plan Will Suit You Best

There are several different types of plans, so it's a good idea to start with research and figure out which type will suit your needs. Typically, you'll have to choose between these types of plans: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), and Point of Service Plan (POS). 

HMOs and EPOs typically require participants to visit providers within their network. You'll have a little more flexibility with a PPO or POS. HMOs and EPOs tend to offer participants lower out-of-pocket costs. If you know you'll be visiting a lot of providers and want to lower your out-of-pocket costs, you might want to consider one of these plans. Do an inventory of your medical needs and determine which services and providers are important to you. Then, you can find a provider who fits these needs. 

Know What's Included in Each Plan

You can't choose a healthcare plan without knowing what will be included. Do your research and determine what services or medications will and won't be included in your potential new plan. Make sure you get a snapshot of each plan you're considering. You can request a summary of benefits, a plan brochure, a provider directory, and a list of the drugs that will be covered, which is important if you need pharmaceutical services in Westfield, NJ. 

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If you're confused about anything in the summary, call the company and ask for clarification. Knowing what's included in each plan will help you determine which one provides the most services you know you can't live without. You also don't want something to happen later, such as the need for major surgery, and you suddenly realize your plan doesn't cover what you need. Think about what's realistic for your current and future needs and look for plans that will match your lifestyle.  

Compare Overall Prices, Not Just Your Monthly Payment

The price of the insurance plan is a huge factor in your decision. You should get health insurance quotes and determine how much each of the plans will cost you. Then, determine how much you would be spending out of pocket with each plan. You should compare your overall monthly costs and decide how much you can realistically afford to spend on healthcare. 

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You also might be surprised by the results. A more expensive plan might actually be cheaper than a less expensive plan when you factor in your out-of-pocket costs. It might sound tedious to do these calculations, but you need to know how much you'll be spending before you commit to a plan. You typically can only change your health insurance during open enrollment or after a life event, like marriage or the birth of a baby. This means you need to thoroughly compare prices and plans and factor in future potential expenses, like an upcoming surgery or the addition of a new family member. 

If you have medical needs, you have to make sure your insurance is meeting them. Know what is and isn't included in the health insurance plans your considering and evaluate your financial status. With the right health insurance plan, you'll have all your medical needs met without breaking the bank.