Comparing Providers: They’re NOT all the same!

January 8, 2014

The online health care exchanges for the Affordable Care Act make it easy to see coverage and prices side by side, but an accurate comparison requires more than numbers on a computer screen. To truly understand what you’re getting and what you’ll pay to get it, you’ll need to do more than scratch the surface of health insurance.

Here are some things to consider during your assessment:

The Big Picture: Overall Cost of Care

A low premium looks great on paper, but don’t be too tempted to enroll in a provider’s plan based on this number alone. While the monthly cost of insurance is definitely something to consider, you’ll be better served by looking at the overall cost of care: that means premiums, deductibles, copays and coinsurance. A small payment each month won’t save you much in the long run when you’ll need to pay thousands of dollars for your co-insurance to kick in. Be sure to look for a great balance rather than simply a low premium.

Going Above & Beyond: Individual Benefits

All insurance is not created equal, although it has been designed to cover the same basic services. Providers want your business, and some are willing to go to great lengths to get it. Look for a company that provides beneficial services above and beyond traditional health care: spending accounts, wellness programs and optional life and disability insurance add value to your plan.

Who Has Your Back: Provider Network

The perfect plan isn’t perfect at all if there are no providers in your immediate area. Out-of-network care often is more costly, and sometimes it’s not covered at all. Be sure the plan you choose includes a wide network of providers where you live. If you’re a frequent traveler or have plans to relocate in the near future, that’s something to consider, too.

Always Plan Ahead: Prescription Drug Costs

Although prescription drugs are covered under the Affordable Care Act, copay amounts can vary widely. If you take several prescriptions each month, you’ll definitely want to find a plan that offers affordable drug costs. Even if this plan comes at a higher premium than others, you’ll save money in the long run.

Pick Up The Phone: Ease of Access

Checking out a provider’s website can offer you a valuable window into its world. Is the site well planned and easy to navigate? Does it allow you to manage your plan online? Is customer service available 24/7? A great health care plan will have a great website to go with it. Be sure you can get in touch with an agent quickly when you have a question about your coverage or need to make a claim.

The Affordable Care Act has taken great steps in ensuring all Americans have access to health insurance, but it’s not always easy to decide which insurer is right for you. Monthly premium costs are important, but looking at the overall cost of care, a provider’s individual benefits and network, prescription drug costs and ease of access will help you to make a great decision. Find out everything you need to know about Covered California in our definitive guide!

You don’t have to go it alone, though. We’re here to help!

Post author Loren Pleet