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Find a health plan that fits you best

October 7, 2009 12:00:00 AM PDT
As congress tries to work out a national health insurance plan, it's also decision time for those who already have health insurance. This is the season for re-enrollment in personal plans, and that means lots of choices and lots of confusion.These are tough times for the health insurance industry and that will likely affect your options. The company you work for is also trying to cut costs, so you need to carefully look at your health plan and choose wisely.

This year's open enrollment period comes when health care costs have reached new highs and employers are trying to save money.

"Employers are just looking for ways that they can help lower their costs, which means that you're probably going to have some higher out-of-pocket costs yourself," said Kim Lankford of Kiplinger.com.

The recession is forcing some employers to switch from offering policies with fixed co-payments to ones where you pay a percentage of the overall cost, meaning the days of paying $10 or $20 could be going away.

But you can still get good and affordable coverage.

First, make a budget after you've determined the maximum out-of-pocket expenses you can pay. Look at regular costs, including how much you usually spend on prescription drugs, co-payment or co-insurance rates for doctors' visits and premiums. You also want to find out what's the maximum amount of coverage you are eligible for over the lifetime of the plan.

"There are some policies out there that limit your coverage to maybe $500,000 for your lifetime, and that could be really, really dangerous," said Lankford.

HMO plans, which limit doctors and facilities to those within the network, are cheaper than a PPO, which offers more choice. But if you go to a doctor or facility out-of-network, be prepared to pay out of pocket.

Another cost-saving tip is to consider a high-deductible plan in combination with a health savings or flexible spending account, where tax-free contributions from your paycheck can be set aside and used to pay your deductible.

If you are married and have a family, see if it would be more cost effective to put your loved ones on your spouse's policy. If you work for a small business that has cut back, it may actually be cheaper for you to buy an individual policy.

"If your family's healthy and you live in a state with a competitive health insurance marketplace, then take a look, go to ehealthinsurance.com or find a health insurance broker at nahu.org, and see what the price would be to include your family on your own policy," said Lankford.

Whether health care reform legislation passes or fails, costs will likely keep rising. But by staying informed, you can get the best coverage that helps you stay within your budget.


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