10 Things you Want to Know BEFORE you Buy Medical Insurance

Know  your health plan. Call your carrier today if you already have a plan.  If you are still looking at the marketplace, use a “navigator” and ask all your questions.  You may not be getting what you think you are buying.  ASK QUESTIONS.  Make sure you know the answers before you are faced with an emergency situation.  
You want to have a plan of action and know the type of care you will receive and what your out of pocket costs will be.

1) Know what your deductible is and what that means when you go for a doctor visit

2) Know which doctors and hospitals are “in network” (costs you less) and which are “out of network” (costs you more), and which systems/facilities are “affiliated” (maybe a reduced fee from out of network or closer in cost to “in network”).  Know what prescriptions will cost more and which ones cost less (generic? copay?)

3) Know what your monthly premium is

4) Know when you should go to primary care, urgent care or the emergency room

5) Know how much will you pay for the initial healthcare visit and then the percent covered when you go to each of those care providers listed in #4

6) Know all about free preventative screenings and which ones you should get and when (schedule those now! An ounce of prevention is worth a pound of cure)

7) Know that “preventative” screenings are free UNLESS, they find something that is diagnosable and then you will be billed (and become aware of your health (bonus)-THE GAME CHANGER)

8) If you find yourself in a hospital or awaiting specialty healthcare in some regard, make sure the person registering you does a “pre-authorization” to make sure your insurance will cover its share

9) It is completely your responsibility to know what is covered on your plan.  Call your carrier to walk you through you the answers to the questions above.  Better than that, know the answers to your questions before you buy

10) Have a family plan of action of where you are going for healthcare for primary care, urgent care and emergency situations 

Also, know what your employer provided healthplan offers in terms of incentives for taking steps to being healthy and making healthy choices.  Sometimes there are premium reductions for doing your part to take care of yourself.  There are resources such as your EAP (Employee assistance Program) for stressful life situations, discounted gym memberships, tobacco cessation classes and more.  Know what those are. 

What I understand is that sometimes people purchase medical insurance through their employer or the “exchanges”/“marketplace”/what most of us know as “Obamacare”;  and are not clear on what they are buying.   It is the “surprise” of what is not covered when we need healthcare and find that the doctor we have established a relationship with over 15 years is not covered on the plan.  Sometime the surprise comes when you have a costly emergency visit because you went to one not covered by your plan.  

Have a strategy and know where your doctors are, which plans (SPECIFICALLY) they are on, and check and double check.  Your MD may take BlueCross BlueShield or UnitedHealthcare, yet it might not be the specific plan you have.  It is our responsibly to ask the questions and know your plan for the best care first and the most economical care as well. 

Most importantly, take care of yourself.  Most of our disease states and health risks are preventable by lifestyle choices.  This is where the cost savings come in and that is probably not a large enough motivator for most.  Don't wait until you are sick to have an awakening.  

The fundamentals of a healthy lifestyle are the same, yet the prescription, goals and motivators for each of us will be different; because each of us is unique.  I can help you learn what yours are, and help you get to your best self. You are complete already, yet life is more fun when you are on track, purposeful, happy and inspired!


Live Healthy. Dream Big.  Be Bold.
Health Inspires.

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