The Checklist for Individual Health Insurance Plans


If you compare and pick from among different individual health insurance plans available in your state, you may be overwhelmed by the sheer number of choices. If this is your first time buying insurance, it becomes even more confusing. You’ll need to know the meaning of terms like deductibles, premiums, coinsurance, and copays.  You’ll then have to navigate the Obamacare website for the options in your state.

Here’s a basic checklist to make things easier for you:

  1. Make sure the plan includes the essential coverage and services you need. One of the benefits of Obamacare plans is that they cover the full cost of a wide range of preventive services for both adults and children alike. If you’re going to get one outside the ACA marketplace, you have to check that the plan you get also includes these essential healthcare services.
  2. See that your health care needs are covered. If you’re taking certain medications on a regular basis, you have to check that these medications are covered by your plan. Many medicines are notoriously expensive, and your expenses can affect your finances if they’re not covered by your insurance.

If you have a family history of cardiac issues, you need a policy that screens for cardiac problems and that covers the drugs you need. If you’re a woman who plans on starting a family soon, you’ll need maternity coverage.

  1. Don’t pay for what you don’t need. Some insurance plans may offer lots of coverage benefits that don’t apply in your case, so that means you’re paying for something you don’t need. A low deductible may seem attractive, but not if you’re young and healthy because that low deductible comes with a high premium. You should get a deductible that’s a bit higher, so you can enjoy lower premiums instead.
  2. Check their network. If you already have a doctor, you may want a network that already includes them. If you go to that doctor and they’re not part of your network, the insurance companies will not pay for your checkups.
  3. Know your out-of-pocket expenses. Many insurance plans involve cost sharing. You have to know the details of these payout schemes, so you know exactly how much you have to pay for possible healthcare treatments. You also have to know the dollar limit on your plan per year.
  4. Evaluate your health insurance plan every year. It’s likely that your premiums will rise for the next year. But it’s also possible that another insurance company can offer you the same coverage at a lower cost. There’s also the chance that your circumstances have changed, so you may need a different type of coverage for your situation.

Check several health insurance plans and go through each one of them to make sure you know what you’re getting. By knowing the details of each plan, you’re more able to compare them properly so you can determine the right plan for you.