Five Important Steps to Take When Selecting Your Health Insurance

Five Important Steps to Take When Selecting Your Health Insurance

Five Important Steps to Take When Selecting Your Health Insurance

Determining the right health insurance plan for you and your family can be stressful. With healthcare costs continuing to rise, enrollees need to think ahead without knowing what the future will hold. Adding to the stress is that open enrollment periods are relatively short, so decisions need to be made under pressure. Picking the wrong plan, however, can be costly.

Check out our list of steps to take to choose the best plan for your family. Our list is designed to help you, whether you are selecting a plan through your employer, through the federal marketplace, or with a private insurance agent.

  1. Choose the marketplace for your health plan. If your employer provides health insurance for you, they are essentially your marketplace. Suppose you do not have insurance provided by your employer or through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or other. In that case, you will want to sign up for a plan through’s Health Insurance Marketplace, through a private exchange, or directly through an insurance agent.
  2. Compare plan options. Don’t let yourself become confused by the numerous acronyms. You’re going to see policies such as HMOs, EPOs, PPOs, and POS plans. Each plan is different and will have varying requirements for in-network and out-of-network coverage, referral requirements, etc. HMO and POS plans require referrals, and in most cases, you will need to see your primary care physician before an appointment or procedure is scheduled with a specialist. If choosing your specialist is crucial to you, a PPO or EPO might be a better option. And, if you live in a rural area, you may be best served by a PPO. High-deductible plans are also an option.
  3. Compare plan networks. If you have a doctor that you prefer and wish to stay with, you will want to research whether or not that doctor is part of the network included with the plan you are exploring. And, costs are usually lower when you see a doctor that is included in your network. If you don’t care who you see, you may wish to seek a plan with an extensive network that provides ample choices and availability. If possible, scratch off your list any plans that don’t have local in-network doctors or those with few provider options compared to other plans.
  4. Compare your benefits. Take a look at the plan summary (summary of benefits) to see which plans will cover a wider scope of services. Some plans may have better or worse coverage for fertility treatments, mental health care, emergency coverage, physical therapy, well-child coverage, etc.
  5. Compare your out-of-pocket cost. This is where the rubber meets the road. Out-of-pockets costs include things such as co-payments, co-insurance, and deductible. The lower your premium, generally, the higher your out-of-pocket costs. During this step, you want to narrow down your choices based on those potential out-of-pocket costs, especially if you have limited means available in an emergency or an unexpected trip to the doctor or emergency room. Think ahead to potential life changes in the coming year as well, such as the birth of a child, a major medical procedure, if you have recently been diagnosed with a chronic illness, etc. These items may indicate you should go for a plan that will pay a higher percentage of your medical costs. Your premium may be higher, but your out-of-pocket costs will be less.

Looking for a Health Insurance Agent to Help You with Your Selections?


If you are looking for assistance with Pawleys Island insurance or want to ensure that you have ample coverage to protect you and your family, Laura Hibbits Insurance can help. Call us today at (843) 979-9204 or send us a message. We’re here to help.

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