Seven Tips for Choosing a Health Plan

Choosing the right health coverage has never been easy, and the health reform law has made things more complicated. Besides sorting through differences in premiums, deductibles, and copayments, new provisions in the law that could impact your coverage need to be considered.

The following tips may help clear away the confusion:

1. Check for grandfather exemptions.
These include free coverage (with no copay) for preventive services like blood pressure or depression screening, smoking cessation programs, and immunizations.

2. Decide which plan type best meets your needs.
An HMO requires that you use physicians within a specific network, giving you less flexibility but more affordable cost. A PPO allows you to stay in-network or go out of network for a heftier fee. POS plans combine elements of HMO’s and PPO’s, giving you the option to pay more for venturing out of network, but usually require you to choose a primary care physician within the network and get a referral from that physician before seeing any specialist.

3. Identify changes before re-enrolling.
That could save you from dealing with unexpected costs if your benefits have changed.

4. Consider adjustments to your current plan or switching.
Take into account whether your needs have changed.

5. Factor in your favorite doctors.
Before electing a different plan, check to see that your primary care physician and specialists are in its provider network.

6. Size up the cost.
If you are healthy, you may want to trade pricey monthly premiums for a higher deductible (paying more out-of-pocket before coverage starts).

7. Don’t get lured by new freebies.
While new plans now require you to pay nothing for certain routine preventive care, you might not need to switch off your old plan to reap this benefit. Many plans were already offering preventive services at minimal or even no cost.