Kworld Trend / The essential checklist for choosing your insurance provider, Health care is complicated (and ridiculously expensive!), especially if you live outside the United States. But it gets more complicated if you plan to live in another country and need global coverage for you and your family.
The unique needs of expatriate life require a high-quality international health insurance plan to provide emergency treatment and protect you when you travel abroad.
Health insurance checklist: What you need to know
There is more to buying health insurance than just signing up. How do you know if you have the right kind of coverage? Or the right amount? Start by determining what your healthcare needs really are. Then you can look at the plans that best cover your needs.
First, it’s helpful to understand some basic terms. A health plan is a contract or agreement that spells out the relationship between you, providers (those who provide health care services) and issuer ( the insurance company that issues the plan). The Plan Benefits Summary tells you :
- Covered Services : Which medical services qualify for coverage and which do not.
- Provider Network : Which doctors, hospitals, labs, and other service providers you should see to get the best rates.
- Monthly Premium : The amount you pay to be covered by the plan.
- Cost sharing : the amount you pay to use health services. This may include deductibles, co-payments, and coinsurance.
The key is knowing the important clauses and understanding where your policy hides critical information that could be costly to ignore. The essential checklist for choosing your insurance provider
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This checklist will show you which items to watch out for and help ensure you get the right coverage while getting the most for your money.
I will cover the topics you should look for in your policy document before purchasing a universal health insurance plan. Included:
- Understand waiting times and how you may not be compensated if you see a doctor, even if you are sick and have insurance
- How to find and negotiate deductibles with your primary insurance company to lower your annual costs
- How to get a refund if you’re not satisfied with your plan’s health care benefits
- What coverage option is needed to ensure you get proper medical treatment if you fall ill in the woods of some remote location in a foreign country
This checklist covers everything you need to know before purchasing international health insurance. Don’t worry – I’ve included links to resources where you can learn more. The essential checklist for choosing your insurance provider
Choose the plan that best meets your healthcare needs
Health plans come in many shapes and sizes. To find out if a plan meets your needs, start by identifying your needs. Then you can compare costs to find the coverage that best fits your budget.
- Which providers? If you prefer doctors and hospitals, check to see if they are in the provider network for any plan you are considering. By using in-network providers, you are always paying the lowest cost for care. Note that different plans from the same insurance company may have different provider networks.
- Who is covered? Decide if you want coverage to include immediate family members.
- What care do you need? The amount and type of care you need affects the cost of the plan. If you are young and healthy, you may not need to see your doctor as much as someone who is older or living with a condition such as diabetes or heart disease.
- Do you take medication? If so, you may want a plan that covers prescription medications. If not, you may want to skip plans that include prescriptions—at least, for now. If your prescription needs a change in the future, you can switch to a plan that includes prescriptions later.
- Planning a family? If so, choose a plan that includes pregnancy and birth care. Otherwise, you can choose a plan that does not cover those services. Either way, most plans cover childcare for the kids.
Understand your costs
Patients with health coverage typically pay two types of costs: The monthly premium is the cost of a plan’s availability for a year. Insurance premiums are paid to the insurance company. Cost sharing is the cost of using the plan when you see the provider. There are three types of cost sharing, and they are usually paid directly to the provider:
- Deductible : The amount you must spend on health care at the beginning of the plan year before your plan begins paying its share of the cost of your care. The discount resets to $0 each year.
- Co-pay : A flat fee that covers your share of the cost of the medical service. The plan usually pays the rest. Co-pay may vary by service.
- Co-insurance : A percentage of the cost of a doctor’s visit, hospital stay, or other health care service. Many plans have a 20% co-insurance for certain services, which means the rest is paid by the insurance company.
First steps
Gather the information you’ll need before you start looking at health plans. Whether you’re exploring on your own or through an insurance agent, it’s good to have this information available for easy reference:
- Social Security numbers for all family members you want to include for coverage
- Income information, such as pay stubs, W-2s, or tax returns
- Policy numbers for all health care plans you have now
- A list of all the doctors, hospitals, and other healthcare providers you use, including contact information
- A list of all the prescription medications you use. The essential checklist for choosing your insurance provider
Important fast food
- Agent : An insurance agent can help you sort through your options, explain the details, and choose the plan that works best for you. They will also advise you if you are facing an important decision about care and help you get the most out of your plan. Sanitas can put you in touch with an agent if you wish. Or contact the Blue Cross Blue Shield chapter in your state.
- Pricing : Understand the relationships between premiums and cost sharing. Low-premium plans aren’t always the cheapest, because they can have high cost-sharing (deductibles, co-payments, and coinsurance). So, look at all costs before deciding which plan(s) give you the best value for your money.
- Network : Understand why it is important to use network providers whenever possible. If you use an out-of-network provider, most plans cover a lower cost—or nothing at all. This leaves you paying more than you would by using in-network service providers.
At Sanitas Medical Center, we work closely with your Blue Cross Blue Shield plan to deliver a simplified healthcare experience, so it’s easy to get the quality care you need at an affordable price. The essential checklist for choosing your insurance provider
Health insurance checklist
This is a list of important policy features and should give you an idea of what to expect from a decent health insurance policy
You must have features | The essential checklist for choosing your insurance provider
Don’t split the bill
Insurance companies may urge you to consider a co-payment clause, in which case, you’ll have to foot part of the bill each time you file a claim. It could be 10%, 20%, or It could be 30% of the bill. So choosing co-pay may not be the best option, unless you have no other choice.
Restrictions on room and room rent
Some insurance companies will not allow you to choose a room that you want. Instead, they will have a limit on the room rent. And in case you go over that limit, they will charge you extra for every little service that is done in the room and not just the rent. At the end of it all, you’ll end up footing a large chunk of the bill. So choose a policy that does not have too many restrictions on this front.
Check disease wise limits
This is what happens when an insurance company offers you huge cover (say 10 lakhs) for a modest fee, only to include restrictions on the amount of that cover that will be available for each disease. So, in fact, you will likely end up owning only a fraction of the 10 lakhs available in most cases.
Choose pre- and post-hospital care
Nobody gets sick right away. You’ll likely undergo a range of diagnostic tests before you’re admitted to hospital. Once you are discharged from the hospital, you will have to worry about medication. These costs can add up. So it is always best to choose a policy that covers pre- and post-hospital care. The essential checklist for choosing your insurance provider
Look for a low waiting period
If you have pre-existing diseases (including diabetes, blood pressure, or thyroid disease), you will likely have to wait a set period before your insurance company can start covering claims arising from these complications. Usually between 2 to 4 years. So it is always better to choose a policy where you do not have to wait too much.
Coverage of day care treatments
Chemotherapy, dialysis, rapid appendectomy. All of these procedures may take less than 24 hours. And even if you are admitted to the hospital to benefit from the treatment, some insurance companies may not cover these claims, because they do not offer “day care treatments.” The essential checklist for choosing your insurance provider
Ask for the recovery benefit
You buy a family insurance policy. you are in the hospital. You are making a claim. Run out of your cover. A few days later, someone else in the family fell ill. But you’ve already used up the cap. The only thing that can help you is the rollback feature, that is, if your insurance company takes back your insurance coverage every time you file a claim. If not every time, maybe at least once? It’s possible. You only have to ask. The essential checklist for choosing your insurance provider
