Health Insurance: 3 Tips for Picking a Plan

Finding the right health insurance plan can be a daunting task, given all the options and variations in cost. University of Rochester benefits expert Scott Latshaw offers tips to help you weigh your choices and pick a plan that suits you.

Your goal in selecting insurance should be to strike a balance so you’re not over-insured, where the cost of the premiums outweighs the value of the plan, or underinsured and possibly exposed to financial risk. Before making a decision, be sure you understand the plans available to you, including what they cover, and what they don’t.

Learn the lingo: It’s not as simple as just understanding the definition of terms—you need to know how they relate to one another. For example, with most plans you will have a deductible for covered health services, which is the amount you’re responsible for paying before your insurance plan begins to pay. A co-pay is a set amount you pay for a covered service once your deductible is met, whereas coinsurance is a percentage of the cost, so it varies depending on fees for the covered service.

If you’re enrolling in a health plan where you work, ask your Benefits Office to explain terms you don’t understand, or check out the glossary of commonly used terms available at HealthCare.gov.

Know your numbers: While you can’t predict the future, looking at the past may help you forecast your needs. Reviewing the last 12 months of statements (online or paper) from your current health plan can paint a picture of what services you (and your family, if they’re part of your plan) used and how often they were needed. Tally up the types of care you needed, tracking well visits, ongoing issues, medications, and treatment for unexpected needs. Are there things you can anticipate in the year ahead, for you or any dependent family members? Ask if your employer offers any tools or calculators to help you use that information to help determine which plan may provide the best coverage at the best rate based on your personal circumstances.

Discover what’s covered: Plans vary widely so be sure you understand what your plan includes. Some medical plans include prescription medications, vision care or dental coverage, while others require you to choose a separate plan for those needs.

Most importantly, tap the resources offered to you—including representatives from your Benefits Office and the various health plans from which you’ll choose. The more you understand about health insurance and how it works, the better prepared you’ll be to make a decision that will meet your needs in the coming year.

Need a doctor? To find a primary care provider who is accepting new patients, please contact us at (585) 784-8891, or toll-free at 1-888-661-6162.

Scott Latshaw is director of University Benefits at the University of Rochester.