Every day I talk to customers that have been thrown into the need to shop for individual health insurance and they are all working toward finding a solution to obtaining coverage at an affordable price.
The agents experience can show you additional options to shopping online alone without any guidance.
Finding the best plan for your situation is the difficult part with all the options that you have never had to think too much about in the past.
The preexisting conditions come into complicate your health insurance selection - Build (height/weight), conditions and regular prescriptions.
The health plan has options to select on deductible, coinsurance, coinsurance out of pocket max, office visit co pays, prescription coverage and monthly premium.
These options can be overwhelming if you have not done this too often.
Of course everyone has a different set of criteria and budget requirements.
The agent can help you find the balance and provide you advice to what may be the best solution for your particular situation.
I typically start with recommending the higher deductible plans from top rated carriers, with deductibles in the $5,000 to $10,000 range to help make the premiums at the lowest levels.
The coinsurance amounts range from 100/0 to 50/50 that the customer can choose a level that they are comfortable with from an overall financial perspective.
The out of pocket maximum and overall financial exposure for a medical issue of accident or illness is the deductible plus coinsurance out of pocket max.
They can decide if an office visit co pay is a must have or nice to have.
One thing that everyone should look at is their previous medical history and personal experience helping to guide their plan requirements.
The agent helps to explain the differences in the plans for the client, and they will have the written summary of benefits to confirm coverage to help finalize the decision.
Reviewing the coverage is an important step in the process to ensure you know what you are buying.
I usually recommend a supplemental accident plan to help cover deductible exposure for any accident related injuries (falls, broken bones, and cuts for example).
The supplemental accident plans help reduce medical deductible of the health plan to the accident deductible to $100-$250 per accident with coverage up to the face amount per accident.
I suggest that the accident plan to at least match the deductible level selected for the health plan.
The cost of this additional policy is usually much smaller than the major medical policy, but still less expensive than a lower deductible policy.
The plans do vary some, so please check the policy you are considering to make sure it meets your needs.
An additional suggestion to the client is a critical illness protection, a supplemental plan that can offer protection on the deductible for critical illness.
The critical illness policy will help cover you if you are diagnosed with a variety of critical illnesses - such as cancer, heart attack and other critical illnesses.
Please check the plan to verify that it covers the major issues and if it will pay for different categories of illnesses at different times for different illnesses.
This plan I usually match to the deductible of the medical policy or they can choose a higher face value to help cover costs while they are recovering.
While you hope that this client never needs to use this plan, it is an inexpensive policy that offers them protection.
The policy usually costs less than the accident policy.
The three policies offer increased coverage for the customer at an affordable price.
This approach does cover a good portion of the deductible exposure for accident and critical illness, but there are still gaps.
If the customer has appendicitis, kidney stones for example, the deductible exposure is there.
They may need to pay out of pocket the deductible and coinsurance amounts to have a medical issues resolved.
So there is some risk, but overall you have a package of insurance that can save you on premiums.
We can usually save our customers $50-$150+ per month with the higher deductible three policy approach.
Talk with your agent to see if this approach can help you save on your monthly medical insurance premiums.
Do not go it alone shopping for health insurance, us an insurance broker/agent to work with you to find the best solution.