Choosing the Right Plan - Health Insurance 101

I got a call from a friend and entrepreneur today.

The last time she called she said, "I stayed up all night reading your book and now I'm freaking out! I haven't had health insurance in 3 years and now I'm afraid I'll lose my home if something happens to me."

After telling her that the book is supposed to keep her from freaking out, we discussed her options, including finding an affordable health insurance plan, and questions she needed to ask before deciding on one.

Today, she called with the results.

"I have two plans from einsurance.com. One is $165/month with a $5,000 deductible and a 40% co-insurance (what she has to pay out of pocket) after the deductible is met. The other is $187/month with a $3,000 deductible and a 80% co-insurance. Which one is better?"

I reach for a pen, pad of paper and more caffeine. Ok, let's see...

What's the lifetime maximum coverage amount? $3 million. Good.

Do they both cover inpatient and outpatient treatment? Yes. Good.

What about exclusions and limitations in coverage? Not sure? Find out.

Is your doctor and local hospital contracted? Yes. Good.

She's close to making a decision but calls the NASE for more options.

They present one of the same health insurance plans but when she asks if it covers inpatient and outpatient care, they tell her, "NO." Not only that, the plan doesn't cover doctors other than at a one time, yearly exam.

What? You don't have to be an insurance expert to know this is a bad deal.

My friend calls einsurance back to inform them of their misinformation and surprise! they find another, superior, PPO health plan for $184/month, a $2,500 deductible with 100% coverage after paying $5,000 out-of-pocket and a $5 million coverage maximum for inpatient AND outpatient treatment.

She's one smart cookie who got an excellent, affordable health care plan because she had the right information and knew what questions to ask.

Health Insurance 101

If you're in need of a quality health insurance plan, compare plans in your state through the NASE, NAHU, and coverageforall.com and save yourself from a "junk" plan that will leave you underinsured by following this checklist of questions:

How much will premiums increase each year? What's the grace period for payments?
What's the lifetime maximum for coverage? Will it cover your chronic illness & supplies?
Does the plan cover preventive healthcare?
Does it cover inpatient and outpatient treatment?
Do you need a referral to access your doctors?
What are your out of pocket costs (deductibles, co-insurance, co-pays)?
What is the maximum prescription drug coverage amount? Are your Rx meds covered?
What are the exclusions and limitations of the plan?
How are claims paid? Will you have to pay out of pocket and then submit a claim?

Remember, an affordable plan must be a quality plan.

The doctor will see you now.