How To Choose Health Insurance

The right health insurance policy can save you money if you want private treatment for an illness or injury. Here is how to find health insurance that covers everything you need.

3 Things To Know Before You Pick A Health Insurance Plan

  • The 4 “metal” categories: There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with quality of care.
  • Your total costs for health care: You pay a monthly bill to your insurance company (a "premium"), even if you don’t use medical services that month. You pay out-of-pocket costs, including a deductible, when you get care. It’s important to think about both kinds of costs when shopping for a plan.
  • Plan and network types — HMO, PPO, POS, and EPO: Some plan types allow you to use almost any doctor or health care facility. Others limit your choices or charge you more if you use providers outside their network.

Compare Estimated Yearly Costs, Not Just Monthly Premiums

It's easy to focus on the monthly premium payment when comparing plans, but Wong at Duke says don't forget to consider other costs as well.

"A lot of people — we know from past research — become overly focused on the monthly premium and may not pay as much attention to things like the deductible or how much the co-payments are," Wong says.

The premium price is prominently featured when you're looking at plans, but look at other costs too. A tool available on HealthCare.gov and some state marketplaces will calculate "estimated total yearly costs" for you. This takes into account the plan's deductible — how much you have to pay out-of-pocket for covered services before your insurance picks up the tab — and copays, put together with how much health care you expect to use in the coming year.

What Isn’t Covered?

Your healthcare insurance won’t usually cover private treatment for:

 

  • organ transplants
  • pre-existing medical conditions
  • normal pregnancy and childbirth costs
  • cosmetic surgery to improve your appearance
  • injuries relating to dangerous sports or arising from war or war-like hostilities
  • chronic illnesses such as HIV/AIDs-related illnesses, diabetes, epilepsy, hypertension (high blood pressure) and related illnesses.

You might be able to choose a policy that covers mental health, depression and sports injuries, but these aren’t always covered.