比较时要问的五个问题 Health Insurance Plans

作者：克丽丝蒂 Caracappa

Whether you’re going from private 保险 to Medicare or just trying to find a plan that works for you, navigating the complexities of health 保险可能会让人不知所措. 我应该选择PPO还是HMO? 高免赔额或高保费? 和 how do I make sure all my medications and specialists are 覆盖?

As Health Insurance Information Coordinator at Washington Hospital, my job is to help make this process a little easier – or at the very 至少没那么吓人了. A free and unbiased service provided to district residents, I work with my clients to help them find the information they need to make an informed decision when choosing a plan that fits their medical needs, lifestyles and incomes. 我们尽最大努力保证 that no one goes without health care just because they’re uninsured 或者保险不充分.

When evaluating plans, here are a few things one should ask:

Are my preferred doctors, hospitals and pharmacies in the provider network?

People are most likely to seek medical treatment when they know it’s 覆盖. That’s why it’s important to make sure your preferred providers, hospitals and pharmacies are in-network – otherwise it may require additional out-of-pocket costs.

我要付多少保险费?

Whether you use your coverage or not, you have to pay a premium to your 保险 company each month in order to stay insured. 这是底边 cost of coverage that doesn’t include co-pays, deductibles or out-of-pocket payments for services not 覆盖 by your 保险. 所以这很重要 that your monthly premium fits within your budget and covers enough to not cause financial strain should you require medical services.

How much will I pay before my 保险 kicks in?

A deductible is how much you have to pay for health care services before 保险接管. For instance, if you have a $2,500 deductible, 保险 will not pay for most 覆盖 services until you’ve paid $2500 directly 医疗费用. These can include anything from a sick visit to prescriptions, 视计划而定. Typically, plans with higher deductibles come with lower monthly premiums, while higher monthly premiums mean lower deductibles. What you choose should depend on your financial situation and ability to pay money for care up front should a medical emergency arise.

What additional costs should I consider?

Even after you’ve met your deductible, you may be responsible for additional out-of-pocket costs like co-保险 (a percentage of the cost of 包括的服务或药物) or co-payment (a flat fee for 包括的服务或药物).

我的处方包括在内吗？?

What medications are 覆盖 depends on your 保险 plan and are often divided into tiers that determine how much you must contribute out-of-pocket 获取它们. If you have a regular prescription that happens to not be 覆盖, you can petition your 保险 provider to obtain coverage, but it’s a lengthy process with results that aren’t guaranteed. Before meeting with clients, I have them write out every medication they take so they’re not blindsided by out-of-pocket costs or left out in the cold if something isn’t 覆盖.

For better or worse, health 保险 is peace of mind, financial security 以及更好的健康结果. 研究显示 that uninsured people have higher mortality rates, receive less timely care and are more likely to go into debt to pay for medical emergencies. They’re also more likely to die prematurely from treatable conditions. Frankly, to go without it is taking a serious gamble with your future.

Rather than forgoing or living with inadequate coverage, you can choose a plan that makes sense for your budget and needs. 知道该怎么做 ask and what to look for is a great place to start.

To learn more about Washington Hospital’s Health Insurance Information 服务访问 partner.e-sportscast.net/health-保险.

发布于2018年9月

关于克里斯蒂·卡拉卡帕
克丽丝蒂 Caracappa is the 健康保险资讯服务 Coordinator at Washington Hospital Healthcare System. 她为社区成员 confidential services to help them make informed decisions about health 保险. The free health 保险 information services are offered year-round and have been noted by community members as instrumental when making 保险 decisions that impact the lives of entire families. 克丽丝蒂 is a regularly featured speaker at community Health & 健康研讨会 focused on a variety of health 保险 topics. 她担任过这个职位 自2009年以来. She enjoys serving residents of the Washington Township Health Care District, where she and her family reside.