5 Tips for Choosing a Health Insurance Company

Here are five tips to choose a health insurance company.

ByABC News
December 16, 2013, 7:15 AM
Here are five tips for choosing a health insurance company.
Here are five tips for choosing a health insurance company.
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Dec. 16, 2013 — -- intro:

It is a historic season for health reform, with many of us holding our breath to see how things unfold. As the Affordable Care Act (ACA) comes into effect, many uninsured Americans are purchasing health insurance for the first time. Whether you're a new buyer trying to choose an insurance company or a current subscriber looking to switch companies, use these tips to find the best value.

quicklist:title: Find the Lowest Cost for Your Health Care Needstext:

Out-of-pocket costs like copays and coinsurance can add up, even though new ACA plans offer free preventive visits. In addition, deductibles for some plans can amount to thousands of dollars each year—in which case you'll need to have money saved up to pay your bill should an accident occur. When comparing across companies, plans with similar benefits may have varying out-of-pocket costs, so you should find a company that offers the right plan at the best price. When choosing a company, consider both your budget, which will determine how much you can feasibly pay in monthly premiums, and your household's likely health needs (and therefore the amount of out-of-pocket costs you will incur).

quicklist:title: Choose the Right Plan Typetext:

Not all insurance companies offer all plan types, so you should choose a plan that meets your needs and then pick a company that offers it. Research plan types: at a basic level, HMOs match you with a primary care provider who is then responsible for any referrals you need, EPOs don't require referrals but do require that you choose providers from within a set network, and PPOs offer more options by covering out-of-network care. Your household's specific health needs will determine which plan type is best suited—if you need more provider options, for example, an HMO won't do the trick.

quicklist:title: Decide How Big of a Provider Network You Needtext:

Doctor and hospital networks vary widely between companies and across the country—for example, ACA plan beneficiaries in many rural areas will have fewer choices available to them than those who live in cities. Even if you've already chosen a company, be aware that some ACA plans have smaller networks than non-ACA plans offered by the same company. A small network might not be a problem if you have a preferred doctor and hospital that you know to be included in a certain company's network—but having more choice can be valuable for some families.

quicklist:title: Check With Your Doctortext:

If you already have a doctor you like, check with the office to see which insurance companies and plans are accepted. This is especially important if you live in a rural area with limited access to health care providers. The ability to retain your current doctor may be a deciding factor if you have a physician you do not want to, or cannot afford to, lose. Besides going to your doctor, you can also visit the HealthCare.gov shopping tool, which provides links to provider directories for each company. This functionality can be useful for health insurance shoppers who want to browse a full list of providers to plan their medical care before making a health insurance decision.

quicklist:title: Evaluate How User-Friendly the Company Truly Istext:

Once you've narrowed it down to a few companies, assess whether their user interface and customer service are a good fit for you. Do you want 24-hour phone assistance, online bill-pay, or other services? Consider how much this is worth to you—if you access care rarely, customer service probably won't be of great importance. But if you expect to require regular assistance with understanding bills or issuing appeals, it might be worth a little extra money each month for a company that has excellent customer service.

This work is the opinion of the columnist and in no way reflects the opinion of ABC News.

Napala Pratini writes for NerdWallet Health, a website that empowers consumers to find high quality, affordable health care and insurance.