- How important is it to you to keep the doctor you
have now? Your answer to this will help you determine whether you need
an HMO or PPO.
- Before calling for quotes, ask your doctor which
companies he works with so you won't waste your time with some
- If you are new to your area make sure there is a
good choice of doctors to pick from.
- Decide how important it is to you to be able to
move around from one specialist to another. Some plans can make you wait
2 to 3 weeks to see a specialist and limit who you can
- How important is it to have little things covered,
like colds or flu? HMO plans can be better for these, although many
non-HMO plans do cover them also.
- If you only want the big things covered, then
decide how high a deductible (the amount you pay first before the
insurance kicks in) you can handle. The higher the deductible, the
cheaper the policy.
- Take a survey of your recent health. Are you
overweight? Pregnant? Currently taking expensive medications? etc. Most
companies worry about these things along with many other concerns too.
Let the agent or company know these things up front, because good agents
know how to direct you to the right company that will take your
- Do you like to get alternative kinds of care...
like acupuncture, homeopathy, massage therapy, etc? Be sure to ask about
how these things are covered because usually these are limited or not
covered at all.
- Also be sure to ask about psychotherapy or mental
professional services if these are a concern to you. Most plans limit
this and you need to know the limitations.
- Have you heard about Medical Savings Accounts? It's
a new thing where you can save money tax deferred in conjunction with
your health insurance. If you are in a high enough tax bracket and don't
mind a high deductible, its worth asking your agent about
- A quick "beware" to you. Every plan out there has
exclusions and limitations. Any brochure you get will have a page or two
of them, usually in the back. Look at them and make sure there are no
surprises. Most are pretty obvious, like sex changes and liposuction
etc. but some may not be so obvious to you.
- A last piece of advice: Using an agent
doesn't cost you anything. They are paid like a travel
agent directly by the company. Buying direct or not doesn't save you any
money. So find an agent who eats, drinks, and breathes individual health
insurance as a living, because you will get the best for yourself. I've
met lots of agents in my 20 years in the business. I have found that the
agents who specialize in this particular niche and have been in business
a long time are good and honest people who believe in a higher goal than
greed. Hopefully you will find this true for you, too.
David Lloyd - Individual Health