Unless you’ve been living under a rock the last few years, you know that health insurance in Florida is a big part of our national conversation. New federal requirements mandate that every individual have health insurance whether they’ve been covered in the past or not. For those who have had pre-existing medical conditions this new law is a god-send as they haven’t been able to get health care coverage in the past, even though they were willing to pay for it.
On the other hand, there are some individuals who have been relatively healthy and have decided to not have health insurance. This may be because they are self-employed or have been in a job that does not provide health care benefits. Either way, these individuals will now have to buy health insurance.
If you find yourself as first-time shopper for health insurance, here are three things to consider:
What Services Does the Plan Cover?
It’s hard to know what kind of health care you may need in the future. One of the good things about the new health care law is they have designated 10 services as “essential” to every plan. They include emergency services, hospital stays, lab tests, maternity and newborn care, treatment of mental health and substance abuse, outpatient care, pediatric care, prescription drugs, preventive services (i.e. physicals, mammograms), and rehabilitation services. If you want to know whether or not a specific service is covered, you’ll want to talk to your insurer or employer.
How Much Will You Have to Pay?
Health care plans require you to pay in two ways. A monthly premium, which is simply the amount of money you’ll have to pay out to keep the plan in force. And second you’ll have to pay some out-of-pocket costs in the form of a deductible and co-pays for prescription drugs and doctor visits. If you or someone in your family has a medical condition that you know will require regular treatment and monitoring, then you should opt for a plan with a higher premium, but with a lower deductible. This will reduce your out-of-pocket costs. If you’re an individual or your family is relatively healthy, you may want to try a plan that has a lower premium. This will mean you’ll have to pay more of your own costs for services, but in the end you’ll probably come out ahead.
Which Doctors and Hospitals Can You Visit?
A doctor-patient relationship is truly unique. Many patients will strongly object to not being able to see their doctor. But every health insurance plan has a network of providers that have agreed to provide their services for a specific price. Your doctor may or may not be part of that network.
If your doctor is not an “in network” doctor, it means you’ll have to pay more, specifically more, for those services.
How to Find More Information
If you’re unemployed or self-employed and shopping an “exchange”, then you can ask see the plan’s provider directory. If you’re considering insurance that is provided by your employer, then you can speak to your employer’s human resources department.