Health and wellness insurance is imperative to ensure that you are well protected for the rainy days. According to a census conducted in the US, in 2019, at least 26.9 million people did not have health and wellness coverage.
While one such certainly hope for the best, it is always advisable to be prepared for the worst. Therefore, make sure to opt for a coverage plan that meets your needs and requirements. Sometimes, one hurdle that discourages people is deductibles.
What are deductibles?
Deductibles refer to the amount that an individual must pay out of their own pocket before their coverage plan kicks in.
For instance, if a given plan has a deductible of $3,000, and the healthcare costs incurred by you are $2,800, you will have to bear the entire cost. In other words, all medical expenses up to $3,000 will not be covered by the insurance provider.
Once the deductible amount is surpassed, and you pay it, the rest of the expense is covered by the insurance plan. After it, you are only liable to pay a coinsurance or copayment fee for the insurer’s services.
Know your deductible
There are different things you need to consider regarding your deductible. This includes the following:
- Certain health plans pay for given types of services even before the deductible kicks in. This can include preliminary checkup as well as disease management program.
- Some coverage plans have varying deductibles for the different services included in the insurance.
- Family plans must meet both family deductible as well as the individual deductible.
Types of deductibles
Here are the major types of deductibles used by health and wellness insurance providers.
- Non-comprehensive deductible
In this type of deductible, certain services are exempted from deductibles. Therefore, you can avail of different health services without worrying about bearing the medical cost.
- In-network vs. out-of-network
Every insurance company has a network of healthcare providers. Your insurance only becomes operational if you opt for services through them. Some plans offer lesser deductibles if you use their network versus the amount charged if you use out-of-network providers.
- Individual vs. family deductible
Individual deductible works, as mentioned in the overview. Contrary to this, the amount can either be met by one member or all in family deductible. Hence, even if one family member uses up the deductible, all others will automatically have the co-insurance kick in.
- Prescription drug deductible
This deductible refers to a dedicated amount that is solely applied to your prescription drugs. This is usually helpful when your coverage plan features a high deductible that cannot cover prescription costs.
Flexible Deductibles – What are they?
For people who find fixed deductible plans a tad too rigid for their needs might find a flexible deductible coverage plan to be a worthy option.
Such plans use your selected network, medical history, budget, etc. to offer flexible coverage options. In other words, you get to have a say on what your coinsurance and deductible combination will be.
This way, you can take into account your insurance requirement as well as the budget to find a deductible that is not difficult to afford.
Such plans also extend to wellness insurance as well. Some insurance providers also allow individuals to add certain services to the plan. This can include prescription coverage, doctor visits, and x-ray costs.
For instance, let’s say your health condition means that you must get certain tests done periodically. You can create a flexible plan with your insurance provider to waive the deductible for the given service.
Tips for choosing coverage plan
Apart from selecting the right deductible as per your affordability, there are various other things you must take into account:
- Select a coverage limit that meets your requirements. Note that the higher the limit, the higher will be the premium charged.
- Know the total cost you will have to bear. This includes both deductibles, out of pocket expenses, and premiums. This will allow you to gauge your investment in the plan.
- Consider high deductibles if you don’t often avail of your health coverage. This ensures that you don’t have to pay a high premium since the two are negatively correlated to one another.
- Always make sure that the plan or insurance provider you select covers the doctors of your choice.
It is not easy to find the ideal coverage plan. However, certain providers who now offer flexible deductible have made things much more affordable for the masses.
While the concept might not be known, now that you are aware of how such coverage plans work, you can make a much better and informed decision.
Regardless of the type of deductible you settle with, just make sure to select a comprehensive health and wellness coverage plan for yourself as well as your family. Your health is surely your biggest asset. Value it. Invest in it.