How do I pick the best health insurance plan for me?

At Benepath, we know that finding the best health insurance plan for you can be complicated since there is no such thing as a one-size-fits-all plan. We understand that the best plan for you and your family will be individualized to your specific needs and circumstances. It is because we appreciate the diversity of our customers that we have created the following list of questions to help you find the perfect plan that fits you like a glove.

1) Are you seeking coverage for a transitional period or are you looking for a plan that will cover you indefinitely?
Many people who are between jobs for a period of 1-6 months may not need to look any further than our short-term coverage options. On the other hand, if you are not planning to participate in health insurance coverage through an employer, the reliability and more extensive benefits offered through an individual and family health insurance plan might be a valuable investment for you.

2) How comprehensive would you like your coverage to be?
Basic coverage generally includes emergency features such as inpatient hospitalization and outpatient surgery rather than coverage for preventative medicine and check-ups. The monthly premium for basic coverage plans is usually much lower than plans with more comprehensive coverage. Depending upon your circumstances and the frequency with which you plan to use your insurance, basic coverage may be the best choice if your primary concern is protection in the event of a serious accident or major illness.

Although plans with more comprehensive coverage have a higher monthly premium, they frequently include features such as office visits, prescription drug coverage, and preventative care in addition to covering outpatient surgery and hospitalization. Comprehensive care plans are usually the best choice for people who will be using their insurance coverage frequently. For example, if you are on a regular prescription medication or if you have a current health condition, comprehensive coverage will most likely be the best choice to meet your needs.

3) Would you prefer to have a lower premium with higher co-payments or a higher premium with lower co-payments?
Almost always, a choice must be made between a higher monthly premium with lower deductibles and co-payments or a lower monthly premium with higher deductibles and co-payments. The best way to approach this question is to determine how frequently you will be using your insurance. If you won’t be utilizing your health insurance all that often, your insurance costs will most likely be less if you choose a higher-deductible plan with a lower monthly premium. If you are on a regular prescription medication or have frequent doctor’s visits, your insurance costs will most likely be less if you choose a plan with a higher monthly premium with a lower deductible and co-payments.

4) How important is it for you to see specialists right away?
A health insurance plan, such as an HMO, that requires the selection of a primary care physician (PCP) will generally not cover specialist visits without a referral. This can be very inconvenient in the event that you are unable to get in to see your PCP and you have a pressing medical need to see a specialist. If direct access to specialists at your discretion is an important feature, you may wish to choose a plan that does not restrict your selection of providers.

5) Do you currently have a specific doctor or hospital from which you would like to continue receiving care?
A large number of insurance plans utilize provider networks. Before choosing a plan, confirm that your current doctor or hospital is a contracted provider with the health insurance plan you select. Additionally, it is important to note that insurance companies sometimes change the providers on their network lists, so you might want to pay special attention to updated lists to be sure your selected providers are still available to you.

6) In the event of an accident or sudden illness, what is the maximum amount of money you would be able to pay out-of-pocket?
Usually there is a certain limit that a policyholder is required to pay out-of-pocket annually. This dollar amount is often referred to as an out-of-pocket maximum. Once this dollar amount is met, the health insurance company will begin to absorb 100% of all other costs for the remainder of the year. If you anticipate using your insurance coverage frequently in the near future, or if you are concerned about what may happen to you in the event of an injury or a sudden illness, the out-of-pocket maximums will be important features for you to review when choosing a plan.

Need Health Insurance?

How do I pick the best health insurance plan for me?

Individual and Family Plan FAQs

What Our Customers Say...