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Published on October 15, 2019

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Choosing the Best Health Insurance Plan

Some decisions in life are more serious than others. Some are more confusing, too, but health insurance plan choices need not be overwhelming.

Take a little time to consider the basics before deciding – knowing your coverage can help you in the event of an injury or illness. Consider this explanation from the experts at Avera Health Plans.

It Starts With Two Branches

The two main categories of health insurance plans are: co-pay and high deductible. Each has its own strengths.

People with co-pay plans will be charged a co-pay when they visit a clinic or urgent care center and have a deductible to meet prior to sharing the cost with their insurance carrier. After you meet your deductible, you pay the co-insurance percentage up to your maximum out-of-pocket amount.

The big advantage to this type of plan is that you can expect lower out-of-pocket costs. The flip-side is you pay higher premiums, which are the set amounts you pay each month for coverage.

Premium prices are directly related to the out-of-pocket costs you pay, in most cases. If you have lower premiums, you’ll likely have a higher deductible and co-insurance percentage.

On the other hand, people who have a high deductible health plan pay out-of-pocket for health services up to their deductible amount. You’ll have to pay that before your insurance covers any of your costs. Having this high deductible allows you to pay lower premiums each month.

A Health Savings Account (HSA) is recommended as good partner in coverage to a high deductible health plan. With an HSA, you can invest tax-free dollars and use the account to pay for certain medical expenses that you would incur before you meet your deductible.

Making the Right Choice

Some people choose lower deductible plans with higher premiums because they know they will have significant health care expenses, including prescription drugs, during the coming year.

People who take the high deductible health plan route are generally healthy or don’t expect to have significant health care expenses. They can then use money that is saved in the lower premium and set it aside to fund a HSA. They should also remember they will need to pay the deductible if that is needed.

Consider the Questions

Before making a final choice, it’s good to review a few basic questions, such as what the plan will cover, the amount of the deductible and co-insurance and the amount of the monthly premium. Remember to figure the premium annually, because it’ll give you a better comparison to a contrasting high deductible plan.

Another good starting point is to do a bit of math and forecast the year to come. You can estimate your possible out-of-pocket costs by considering clinic visits, hospital care or prescription drugs you may need. You’ll want to think about how much your co-pays cost, deductible and out-of-pocket maximum.

Use What's Yours

Health insurance plans do cover certain things completely – so get your money’s worth by making your annual wellness visit appointments. You can also set up and go to preventive screenings that are recommended for your age and gender, such as mammograms and Pap tests, along with colonoscopies and immunizations.

Your health insurance plan may also offer value-added services that help you stay healthier and that over time will pay off. See if you can get fitness center discounts or memberships, low-cost or free virtual visits and health education or coaching through the one you pick – many plans offer some or all of these helpful features.

The best way to ensure you’re getting a good return on your investment in health insurance is by talking with the agents who offer the coverage. They can compare the choices, give you accurate information on the price differences and answer your questions about all the plan’s features.

Insurance decisions may seem confusing or overwhelming. To get help with your questions and discuss your plan options call an agent or visit AveraHealthPlans.com.

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Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

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