Costs are lower whenever you visit a physician within your network because insurance companies get lower rates within their network of providers. Whenever you go outside the network, the physician may not have contracted rates and the costs will make you and the insurance company pay more.
If you have a physician and you want to continue seeing them, check if they are within the provider directories for all the plans you’re comparing. You can also ask your doctors directly if they have a preferred health plan.
If you don’t have a preferred doctor you might want a plan that has an extensive network so you can have more choices. It is important to have a large network if you live in the rural parts of Florida because you will probably want a local doctor who is part of your plan.
There may be limits on the total money you spend out of pocket every year. In general, if you minimize your premium, you’ll probably face higher out-of-pocket costs throughout the year.
There may be a variety of cost-sharing options so narrow down the choices by your out-of-pocket costs. It may be better to get a plan that pays a high portion of your medical expenses if:
a) You frequently see a specialist or primary physician.
b) You are in frequent need of emergency care.
c) You regularly take expensive branded medications.
d) You have small children, expecting a kid or planning to have a child.
e) You have plans to undergo surgery.
f) You have a recent diagnosis of a chronic condition like cancer and diabetes.
2) Compare the Benefits
You may have narrowed down your options to just a few by this moment. You can further narrow this down by going back to the summary of benefits to check which plans have a wider scope of services in their coverage. Some plans have a better coverage for things such as mental health care and physical therapy. Others may have a better coverage for emergencies.
Skipping this important step can make you miss a plan that is better suited for you and your loved ones.
After narrowing it down to a few options, start addressing the lingering questions. In some cases, you can do this if you only speak with a person. We suggest talking with a licensed independent insurance agent who specializes in Health Insurance like the SunGate Insurance Agency here in Lake Mary. Write down your questions in advance and make sure that you have a pen and paper ready to record the answers.
Your questions should have a basis on your current health situation. Here are a few examples that people should ask:
a) I take particular medications. Will it be under coverage in the plan?
b) What are the drugs for my illnesses that have coverage in this plan?
c) What are the maternity services in coverage?
d) What will happen if I get sick while traveling abroad?
e) How can I start to sign up and what are the needed documents?
At the Sungate Insurance, we care about getting you and your family the right insurance protection and we have access to all the best health insurance options in Florida. To learn more about how we can help you, please contact our agency at (407) 878-7979 or Click Here to request a free quote.
