Finding the best private medical insurance means finding private medical insurance that meets your anticipated medical needs at the most affordable cost to you. However, simply comparing plan options for covered medical services along with your expected costs are not enough if you want to find the best plan for you and your family. You also need to review reliable indicators of how well your potential healthcare plan serves its current members. After all, if the company providing your healthcare plan doesn’t put a priority on providing the best service to its members, this could result in your plan making day to day medical service coverage decisions on behalf of you or your family that are not the best in terms of the medical care you could have received by using another medical insurance company and plan.
I suggest the following approach to organizing your search for, and choosing, the best private medical insurance plan for you and your family. First, assess your anticipated medical needs and the needs of each member of your family. Second, determine whether flexibility in your choice of medical service providers like doctors or hospitals is more important than predictability of your out-of-pocket cost for the plan coverage period. This will help you make sense of the medical insurance financial terms when comparing plan options. Next, find a way to independently evaluate the quality of medical plan companies that meet your requirements for covered services and costs. This article will briefly take each of these in turn to help you get started with your search and choice of a private medical insurance plan.
Assess the medical services that you and your family might need during the plan coverage period. For example, a young man that is single and healthy might only forecast that his foreseeable medical expenses are the slight chance that he will be involved in a life-threatening or injurious accident or that he might contract a totally unexpected, serious illness. In this case, the young man may simply want catastrophic type coverage or an indemnity health insurance plan where his premiums are lower in exchange for a larger deductible and co-insurance.
On the other hand, a married man with young children and the strong possibility of another child on the way would most likely opt for a more comprehensive managed healthcare plan that provides fixed co-pays and a lower or no deductible in exchange for higher premiums. Further down in this article I provide a link to a couple of good resources that can help you get started with building the list of medical services you and your family need covered by a medical insurance plan.
Once you have your list of medical services for which you and your family anticipate needing coverage, the next item to consider is how you want to manage your out of pocket costs for medical services received. This was touched upon in the previous paragraph but it basically comes down to this – do you want an indemnity health insurance plan where you choose your doctor, hospital and other medical service providers and your insurance reimburses or pays directly a percentage of the fees that you are charged? These types of plans provide great flexibility but you would pay more out of pocket when you do have to see a doctor or go to the hospital.
If you need more predictable out of pocket costs, you should consider a managed service plan like an HMO or PPO. These restrict the doctors, hospitals and other service providers that you can use as well as imposing more stringent requirements for when and how you get referred to a specialist – and your premiums will most likely be higher. The benefit in return is that your out of pocket expenses are more predictable with fixed out-of-pocket co-pays and lower deductibles. Managed care plans also pick up a major share of the costs for preventative care that can otherwise be expensive for a young family with children.
The two videos that you will find at the end of the article on this site entitled “Medical Insurance Broker” provides a good overview of the medical needs and the financial considerations you should consider for choosing the plan that has the best out of pocket costs while providing the medical coverage needed by you and your family.
Just because you find a medical insurance plan that covers your anticipated medical service needs, and is the best choice for you and your family in terms of flexibility of provider choice or predictability of out of pocket costs, this does not mean it is the best plan to purchase. You need to compare the plan you found with similar plans to be assured that the quality of the coverage and services you receive from your healthcare plan is what you expect. This is where you need a way to evaluate quality of service criteria for the medical insurance plan. This criteria might be the number of doctors to choose from in the plan’s network, waiting times to get an appointment with doctors in the network, hospitals you have access to, how well the company handles your problems, and the number and frequency of forms you have to fill out before the plan will pay for the medical services you received.
A good resource for assisting you in what to think about when evaluating the quality of a medical insurance plan can be found at this link. There you will find the page at the Agency for Healthcare Research and Quality (AHRQ) site that provides not only quality considerations for a healthcare plan but further down the page you will also find a list of medical services you should consider when deciding the coverage you and your family need as discussed earlier in this article. AHRQ is an agency of the United States Department of Health and Human Services.
It helps to have an independent way to evaluate companies that you are considering for the purchase of medical insurance coverage. Even if you use a medical insurance broker, it helpful to know you have a means of performing your own evaluation. The National Committee for Quality Assurance (NCQA) provides a report card of managed healthcare plans (which are the types you are most likely to choose from if you have a family and need comprehensive care and predictable costs). You can find the report card at this link. Also scroll down the center of this page on the NCQA site for links to further information for finding quality healthcare plans.
In summary, to find the best private medical insurance plan for you and your family, first assess the medical needs for which you and your family anticipate needing coverage, determine how flexible or predictable you want the plan to be for choosing medical service providers and understand how this affects your out of pocket costs, and find a way to evaluate the quality of service from a healthcare plan using publicly available resources to do this.
All the best in finding and choosing the best private medical insurance for you and your family.