Getting enrolled to an insurance plan especially a health cover is a big investment that determines the ability to access quality health facilities, quality sleep, and financial stability. However, with so many plan choices and nuances of the fine print, mistakes are simple to make when choosing. Avoid these 12 common health insurance mistakes as you shop for coverage:Avoid these 12 common health insurance mistakes as you shop for coverage:

1. Lack of Knowledge on the Various Forms of Plans 

Major categories of health insurance plans are HMO, PPO, POS and HDHP/HSA. Educate yourself on the specific variations between different plan models – options for providers, deductibles, copays, coinsurance, out of pocket maximums, prescription coverage and preventive care. Be familiar with the subject that you are comparing.

2. Targeting Only the Premium Price

A low-priced health insurance premium is not always synonymous with an affordable healthcare plan. Co-payments, annual deductibles, and total out-of-pocket may also differ from one plan to another. Add up your projected premiums and out of pocket costs for healthcare that you expect to spend in the next year. 

3. Overlooking Network Limitations

Be sure to check the provider network and the hospitals that are affiliated with each plan. The following example shows that even PPOs can have large network constraints: Make sure your favorite doctors, specialists, pharmacies and health systems are in-network if you want to get the maximum coverage. When you use out-of-network providers, you are likely to be charged more.

4. Failure to Verify Prescription Drugs Insurance 

If you are currently on any prescription medication, ensure that the medication is on the plan’s formulary list at preferred coverage levels. You need to exclude the plans that do not include your required medication, or those that will make you pay high copayments or coinsurance for your medication. 

5. It also assumed that all health plans include specific services.

Remember that standard insurance programs may not necessarily include such services as maternity care, mental health services, physical therapy among others. It is important to scrutinize what is and is not included in the plan and to what degree (coinsurance percentages). Ensure the plan covers your future healthcare needs.

6. Excluding Dental & Vision Plans

Dental and vision care are usually excluded from most health insurance plans that people purchase for themselves. If these services are relevant to your family, opt for separate dental and vision coverage. They offer coverage for regular check-ups, tests, vision, etc. , which are usually excluded by most typical medical insurance.

7. Failure to Monitor Annual Performance & Administrative Performance

There are some factors that consist of client satisfaction scores, consumer ratings, trends in the costs of premiums over the years, the rates of denial and preciseness of claims processing by the chosen insurance provider. This provides information on how the insurer carries out its operations from one year to the other.

8. Lack of Assessment of Telehealth and Virtual Care Services

Virtual care and telehealth increased its use over the period of 2020/2021 due to pandemic outbreak. Find out which telemedicine services are covered by each plan and which ones are excluded. Phone/video consults, mental health care, and chronic care management are some of the best features of virtual care. 

9. Failure to Understand Special Enrollment Period 

He or she should not be pressured to select a health insurance plan only during the annual enrollment season in the fall. There are ‘Special Enrollment Periods’ or ‘SEPs’ that occur in response to some qualifying events like job loss, relocation, marriage, divorce, birth of a child, turning 26, and some changes in income. This generates other 60 day opportunity points to sign up during different parts of the year in case of other needs.  

10. Taking It for Granted That Your Doctors

The networks of insurer providers and the formularies of covered drugs can shift every year. The plan you have selected might be changed by the next open enrollment period. It is wise to make a hard copy or electronic copy of the provider directory and the drug formulary for future use in case of any changes that may not be revealed the first time the enrollee is joining the insurance plan.

11. Delays in Carrying Out an Analysis of all the Parameters 

It is not wise to delay the process of comparing health insurance plans until the time that is left is limited. It takes time and effort to go through all the details and to make comparisons against your situation. Make sure to have a good number of weeks to spend on your research before the picks are expected. Making hasty decisions without proper considerations usually leads to regrets or poor decisions being made.  

12. Non-Reading of the Fine Print
 
The policy documents of health insurance and other related contracts have print-small letters concerning elements such as the coverage exceptions and restrictions, things that may not be covered, things that may require prior approval and so on, which exert influence on your cost burden. Review the more specific plan documentation and query the language or limitations that you do not understand or feel uncomfortable with. Never skip parts thinking they are not relevant to your case.

It is virtually impossible to avoid all the health insurance selection mistakes but being an informed consumer with perception of different plan variables puts one in the best position to get the best deal. As you go through enrolling, it is wise to consider the likelihood of each of these problems so as to make the best plan decision.