January 31, 2023

Comparing health insurance plans is a very important aspect of the due diligence which should be undertaken prior to choosing health insurance. In comparing plans close attention should be paid to the differences and the similarities between the plans, and priorities should be established as to which variables are most important in the decision-making process. The most common considerations are costs benefits, and healthcare flexibility.

Comparing health insurance plans can be best achieved via a health insurance exchange, whether it is one of the government exchanges, also known as marketplaces, or a private exchange. With a few clicks of a mouse and strokes of a keyboard most of the information for comparing plans before choosing health insurance can be obtained with a minimum expenditure of time. The process is not only fast and efficient, but is also educational. With the correct entry of your zip code, age, smoking status, desired plan type and desired plan features it is possible to obtain instant information including the monthly premium, deductible, copayment, if applicable, and other details of any plan(s) with a side-by-side comparison of multiple plans.

The monthly premium is only one aspect of the cost of coverage. Depending on the plan chosen, additional costs include copayments, deductibles and coinsurance which can all be compared between various plans. In addition to these individual out-of-pocket expenses, the private health-insurance-exchange platform will also allow you to compare the maximum annual out-of-pocket expenses between different plans and will indicate whether or not the annual deductible is applied toward meeting those maximum expenses.

Benefits that can be compared include lifetime benefits stated as a dollar amount or unlimited, out of network coverage, out of country coverage, cost savings for a major, midsize or minor event compared to not having insurance coverage, preventive care coverage, emergency and urgent care, prescription drug coverage, inpatient coverage, outpatient coverage, pediatric services, maternity coverage, mental health coverage, substance abuse treatment, and additional coverage for things such as chiropractic treatment, skilled care and nursing home services, home healthcare, durable medical equipment, dental services, vision services and hospice services.

Healthcare flexibility details which can be compared between plans via the private exchange platform or the government marketplace include the plan type (PPO versus HMO), if a primary care physician (gatekeeper) must be selected, whether or not specialist referrals are required, and whether or not authorization is required for accessing out of network benefits. Additionally, plans can be compared on the basis of their A.M. best rating.

Choosing plans to compare prior to the actual comparison process, can also be efficiently accomplished with the health-insurance exchange platform by sorting plans based on insurance company, monthly premium, plan type, deductible, metal level, coinsurance, health savings account eligibility, and the additional benefits of prescription drug coverage or dental coverage.

If obtaining healthcare from a particular physician(s), at a particular hospital(s), or at a particular outpatient center(s) is extremely important, the exchange platform will enable you to determine whether or not a physician(s), hospital(s), or outpatient center(s) is a preferred provider, prior to choosing healthcare insurance, if the plan under consideration is an HMO or PPO network plan.

Choosing health insurance plans to compare and making the actual comparisons, not only helps you to determine the differences and similarities between various products, but is an educational process which most likely will expand your knowledge of medical insurance in general. Additionally, this choose, compare, then choose approach increases your likelihood of choosing health insurance that is most suitable for your needs and goals.