Making Your Medical Insurance Work for You

2007-03-08 10:33:40

( Insurance )



Whether you buy it through your employer as group health or by yourself if you are self-employed, medical insurance will cost you. The key is to choose the one that would best fit your needs and your budget, and then use it efficiently.

Choosing a Medical Insurance Plan

If you are employed, your choices are limited to whatever your employee benefits department has to offer. If you're self-employed, you can look through various websites and the phone book yellow pages. Friends and relatives can also refer you and can provide insider information about the quality of doctors and services.

Find out how each insurance company is set up and the medical services offered, as these will affect the cost of coverage.

The indemnity set-up is generally more expensive than managed care organizations, such as HMOs. This is because the indemnity type gives you the most freedom to choose any doctor or medical facility, while the other set-ups are bound by networks.

Carefully check on the services that are covered by each medical insurance plan to make sure they suit your needs. If you have a family with young children, you would want well-baby care and immunizations to be covered by the medical plan. Also verify if the plan will cover pre-existing conditions, such as pregnancy, as some plans require a 12-month waiting period before the condition is covered.

Also find out the geographical extent of the coverage. International medical insurance companies are generally able to cover services anywhere around the globe, but are most expensive as well. Cheaper plans will cover only services within the country.

Finally, you also need to find out how much you will pay monthly. If you are employed, your employer will bear part of the monthly fees, but if you're self-employed you would have to shoulder them yourself. You also need to know if there are deductibles and copayments required before the insurance company will start covering your medical bills. By all means, get medical insurance quotes from as many companies as you can, so that you could make comparisons before choosing any.

Using Your Medical Insurance Plan

Now that you have a medical plan, use it not just for emergency cases but also for preventive care. Choose your primary care physician carefully based on recommendations of those who bought the same plan. Visit your doctor regularly for routine check-ups and avail of tests such as PAP smears if covered.

You will need to work closely with your primary care physician, who will maintain your medical records and refer you to specialists. Unless you're under an indemnity plan, do not just go to any doctor without first finding out if he is within the network, as you could incur extra costs.

When you have to avail of emergency or out-of-network services, coordinate well with your primary care doctor and the insurance company on how the bill will be paid and what part you are responsible for.


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