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5 Steps to Simplifying Health Insurance

Pacific Prime works with international insurers and offers expert independent advice to clients. Here are the first five steps you can take to better understand health insurance.

Posted on Jun 16, 2014 by Alex Nellist

1 - Think About Now – And The Future

When choosing an insurance policy, the first step is to ask: what health benefits do you need at the moment? If you’re under 35 and in relatively good health, you probably want coverage for unexpected accident or injury – you’re not anticipating a diagnosis of heart disease any time soon, but it would be nice to know that if you fall down an escalator and break your ankle, you won’t go into bankruptcy. At the same time, it’s important to choose an insurance company that can offer services and guidance now and for many years to come. The plan you pick today may not be the plan you stick with 30 years from now, but you can still prepare for the future today: engage with a reputable, helpful insurer that offers a range of plans, so that if your health care needs change, you’ll have a support network ready to help you upgrade or alter your health insurance policy.

2 - Understand Your Costs 

Insurance plan pricing can seem complicated, but there are really just two basic costs you need to understand: premiums and deductibles. A premium is the bill you pay every month (or in some cases every year) to your insurer, regardless of what health services you have used. Think about your premium as a membership fee: it’s what you regularly pay for the privilege of being on your chosen health plan. 

A deductible, on the other hand, is what you pay to access health services. But, doesn’t insurance pay for those health services? Yes; however, most insurance companies also ask that you pay part of the cost, first. Some health plans may ask that the customer pay the first US$200 of the year’s medical services, after which point the insurer will cover the rest. Another plan might have an even higher deductible, requiring the customer to pay the first US$2,000. That’s a lot of money, but keep in mind: a high deductible usually means low premiums. 

When shopping for the perfect insurance plan, you must also consider the cost of co-pays (a fixed amount you pay for a medical service, such as visiting the dentist), out-of-pocket maximums (if you reach your maximum in a year, through paying deductibles, co-pays and other costs, your insurer must cover 100 percent of all other health care), and yearly or lifetime limits (the maximum amount of money that your insurer agrees to spend, in a year or lifetime, on your medical needs). 

3 - Choose Your Network 

Many insurance plans only cover services within a specific network of doctors, hospitals and other health care clinics. For some customers, that’s good news: a health insurance plan can offer access and referrals to better physicians that the patient might have found on their own. On the other hand, some customers might find that joining a new health insurance plan means giving up a former, trusted doctor.

Once you’ve found a health insurance plan that looks promising, investigate its network: are there physicians and clinics close to where you work or live? Will you be comfortable bringing your health care needs to the caregivers available? Are you looking for any specialists, an ear nose and throat doctor for example, that the insurance network won’t be able to provide? Think carefully about all of these questions before proceeding with your purchase.

4 - Special Needs

Find a policy that suits your need precisely: if you wear glasses, find a plan that offers optical coverage; if you have chronic back pain, find a plan that covers visits to the chiropractor; and if you’re accustomed to regular visits with a therapist, find a plan with a network of psychological services. Whatever your special needs may be, there is – usually – a policy suited to your health care situation. Frequent travelers might prefer an insurance plan that offers coverage abroad, and those who engage in adventure sports or work a high-risk job can find a plan with more comprehensive coverage.

When considering your special needs, also consider whether you want an insurance policy that covers you alone, or one that offers care for a spouse or children, too. Many individual insurance plans will also cover partners or dependents – and putting the whole family on one plan may make the most financial sense.

Pacific Prime understands that finding and comparing all this information can be a daunting task and that sometimes, you just want to view the necessary facts at a glance. We value our customer’s time and as a result, we’ve created a unique quote comparison table to help you on your journey in finding the perfect plan for you or your family.

5 - Ask Questions

When researching health care plans, get in touch with the plan provider and ask questions – if the response you receive isn’t timely or helpful, that’s a good sign that you shouldn’t purchase the plan. A good health insurance provider should be able to answer questions about costs, network and other policy details; information that’s essential for the customer to have when shopping for a plan and once that plan has been purchased. If an insurance company can’t answer your questions, look for one that can.

Pacific Prime works closely with both local and international insurers and offers expert independent advice to help you find the perfect insurance solution to suit your needs. Whether you are searching for a plan just for yourself, your family or your business, our team is always happy to help and can be easily reached at any of our international offices. For more information, or to receive a free quotation, contact us today.

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