Make the Right
Health Insurance Choice
Step 6

This section will help you make the right health insurance choice, by guiding you through the process of comparing your health plans.

If you followed the previous steps, you now have a number of health plan quotes to choose from.

And if you're feeling a bit overwhelmed and having difficulty making your health insurance choice, don't worry.

Here, you will find guidelines that will enable you to evaluate and compare health insurance plans using the factors that are critical to you and your family.

Pull out the needs assessment worksheet that you have completed in Step 2 - Assess Your Health Care Needs. You will need to refer to your worksheet answers often as try to make your health insurance choice.

• your choice of health care providers (doctors, specialists, other providers, and hospitals),
• the medical care you will receive,
• the level or quality of care/service, and
• how much you will pay

Do you want coverage for your whole family or just yourself? Are you concerned with preventive care and checkups? Do you need maternity care? Are you comfortable in a managed care setting that might restrict your choice somewhat but give you broad coverage and convenience?

These are questions that only you can answer, and are critical to making the right health insurance choice.

Hopefully, the Health Insurance Needs Assessment worksheet provided in Step 2 has helped you do this.

Review your answers to the worksheet again. Include additional information that you may have left out. Then, proceed to review each plan thoroughly. Examine the health insurance plan’s benefits summary or outline of coverage.

Read the description of the policy benefits, exclusions and limitations. Understand how much it costs and (premiums, deductibles, co-pay, coinsurance) compare it with others.

Making the right health insurance choice, with the right balance of health coverage and costs, can be challenging. Make sure that the health insurance you choose offers you the medical care that you and your family need and that it meets your budget.

So take your time. Compare the plans.

Health Insurance Plan Comparison Worksheet.

Write the health plan names under each option. Add column/s if you need to. Read and think about each criterion carefully and fill out the corresponding column for each plan.

Health Care Criteria	Plan A	Plan B	Plan C
Plan Name	______	______	______
Access to providers	PLAN	PLAN	PLAN
Can I see any doctor of my choice?	Y N	Y N	Y N
Are any of my doctors in the plan? List Names:	Y N	Y N	Y N
Can I see other types of doctors/specialists?	Y N	Y N	Y N
Are hospitals/facilities near where I live or work?	Y N	Y N	Y N
Can I go to other hospitals when I travel?	Y N	Y N	Y N
Do I have to wait long for an appointment?	Y N	Y N	Y N
Medical Care		PLAN	PLAN
Does the plan provide benefits I need?	Yes or No?	Yes or No?	Yes or nO?
Preventive care and routine check-ups	Y N	Y N	Y N
Hospital care	Y N	Y N	Y N
Surgery (inpatient and outpatient)	Y N	Y N	Y N
Medical tests, X-rays	Y N	Y N	Y N
Mammograms	Y N	Y N	Y N
Maternity care	Y N	Y N	Y N
Well-baby care	Y N	Y N	Y N
Physician Visits	Y N	Y N	Y N
Mental Health Care	Y N	Y N	Y N
Skilled Nursing Care	Y N	Y N	Y N
Drug and Alcohol Abuse Treatment	Y N	Y N	Y N
Prescription Drugs	Y N	Y N	Y N
Home health care visits	Y N	Y N	Y N
Rehabilitation Facility Care	Y N	Y N	Y N
Physical Therapy	Y N	Y N	Y N
Speech Therapy	Y N	Y N	Y N
Hospice Care	Y N	Y N	Y N
Chiropractic Treatment	Y N	Y N	Y N
Acupuncture	Y N	Y N	Y N
Dental Care	Y N	Y N	Y N
Vision Care	Y N	Y N	Y N
Other Services I need	______	______	______
Other benefits offerd by the plan	______	______	______
Preexisting condition that I may have	Y N	Y N	Y N
Cost/Cost Management	PLAN	PLAN	PLAN
Does the plan handle claims?	Y N	Y N	Y N
Premium/Year	$______	$______	$______
Deductible/year for medical care Deductible/year for prescription drugs	$______ $______	$______ $______	$______ $______
Co-pay per doctor’s visit Co-pay per prescription Co-pay per hospital visit	$______ $______ $______	$______ $______ $______	$______ $______ $______
Co-insurance rate	$______	$______	$______

In addition to the above factors, when making your health insurance choice, you may also wish to check on the health insurance plan’s financial ratings as well as its customer satisfaction ratings.

Financial Ratings

The A.M. Best Company, Standard & Poor’s Corporation, and Moody’s all rate insurance companies after analyzing their financial records. These publications that list ratings usually can be found in the business section of libraries.

Most companies providing health insurance quotes online also display the latest ratings for each health insurance company, along with the quotes, for easy reference.

Consumer Satisfaction Ratings

You may also wish to find out what members of the plan say about the plan and how they rate it on the factors that are important to you. This type of information is called consumer ratings or consumer satisfaction information.
The Agency for Health Care Policy and Research has developed a consumer satisfaction survey called Consumer Assessment of Health Plans (CAHPS®).

The information from this Survey helps you compare plans and choose the health insurance that's right for you and your family.

This information include ratings on factors, including: satisfaction with the health services received, ease of securing appointments, quality of service from doctors and other health care providers, staff performance.

Ask your employer or the insurance company for a CAHPS survey or other consumer ratings report. You may also contact your state department of health or insurance commissioner for information.

Furthermore, to make the right health insurance choice, talk to your family and friends. Ask them about their experiences with their health insurance coverage. They would be an excellent resource, particularly if they belong to one of the plans you are considering.

Now that you've chosen the health insurance plan for you and your family, proceed to the final step.

Find out what you need to do in order to avoid problems with your health insurance application.

7 Steps to Getting Affordable Health Insurance

Step 1: Know the Health Insurance Terms.

Step 2: Assess Your Health Insurance Plan Needs.

Step 3: Which Health Insurance Type is Right for You?

Step 4: Where to get Health Insurance Coverage.

Step 5: Get the Best Health Insurance Quote Available.

Step 6: Make the Right Health Insurance Choice.

Step 7: Submit your health insurance application.

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