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Small Business Employee Benefits and HR Blog

5 Tips for Finding the Best Health Insurance Provider

With open enrollment for individual health insurance coming up, many Americans are re-evaluating their health insurance needs or purchasing health insurance for the first time. The consumers who are most impacted by this are uninsured individuals or employees who purchase their own health insurance coverage. With a shortened open enrollment season this year, it is vital that consumers are selecting the right insurance company and plan for them. Here are five tips on finding the best health insurance provider.

1. Work With a Health Insurance Broker

While the individual health insurance Marketplaces have made it easier to compare health insurance options, many consumers are not comfortable selecting a plan on their own. A licensed health insurance broker can be very helpful to educate consumers about the different health insurance plans and options.

In addition to helping consumers break down the healthcare literacy barrier, they can aid in determining whether their clients are eligible for premium tax credits and cost sharing subsidies.

2. Select the Right Coverage for Your Healthcare Needs

In the past, it was hard to understand the coverage levels of plans. That’s no longer the case. As of 2014, individual health insurance plans are categorized in four standardized levels of coverage, called “metallic tiers of coverage.” These categories help consumers better compare plans “apples to apples.” In order to save money, it is important for consumers to select the right metallic tier for their health and financial needs.Metallic_tier_plans

If a consumer anticipates using a lot of medical services, it is more ideal to select a platinum or gold plan. Although the premiums higher, there will be less out-of-pocket when it comes time to receive medical care. If a consumer doesn’t anticipate having a lot of healthcare needs, selecting a silver or bronze plan is more ideal to save money. Although there will be higher out-of-pocket costs when medical services are needed, the premium will be significantly lower.

3. Select the Right Plan Type

There are different plan types offered by different health insurance providers. In other words, they are structured in different ways to offer different benefits to consumers. For example, HMOs match consumers with a primary care provider who is then responsible for any referrals while PPOs offer more options by covering out-of-netowork care. See: Four Common Types of Health Insurance Plans

 

4. Check the List of In-Network Providers

This is especially important if a consumer has a preferred physician or medical center. To check if a particular doctor is “in-network,” consumers can check with their doctor’s office to see if they accept a certain health insurance company. Alternatively, the health insurance company should provide a list of in-network providers upon request.

5. Make Sure There is Great Customer Service

If the decision comes down to a few different health insurance companies, a great deciding factor is to asses their website and customer service departments. Some insurers offer 24 hour assistance, while others offer online bill pay. Before enrolling in a health insurance plan, it is vital for consumers to check and make sure that their company of choice offers great customer service.

 

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