One of the first things you should be doing is taking a hard look at your possible maximum out of pocket expense, also called your co-insurance maximum. Before you lay out any money, know the figures first. The dollar amount indicates the max you may spend in a year on in-network and out-of-network medical expenses. Put another way, you'd get the costs (roughly) for the deductible and co-insurance limit.
For this next tip, you need to read the fine print on your policy. There are a lot of companies that have pretty good lifetime maximums for expenses during the life of your policy. If you've got a figure that's close to or slightly over $3 million, that's usually good enough. Here's where you read the fine print - some plans have a per incident/per year maximum and they supersede the lifetime maximums. So beware.
Just about everyone has a budget. Have that in hand when you go health insurance shopping. Hook up with a good insurance agent who is able to walk you through comparable plans with all his carriers and be on the same wavelength as your budget. This saves time and ultimately money.
You'll find enormous differences between carriers for the various Medicare supplement plans so don't be too surprised. Just make sure you have a calculator to run figures to see which plan suits your financial situation.
There are two major networks in Texas for family and personal health care plans - the Health Maintenance Organizations (HMO) and the Preferred Provider Organization (PPO). HMO's are reasonably priced but you will give up being able to go to any doctor you want. If you happen to need regular medical care outside your HMO area you foot the bill yourself, period.
PPOs let you go to any doctor you want, but the insurance company pays more if you head to a facility that takes your insurance company. Call this scratching each other's backs at the expense of the consumer. Basically if you want good prices, service and options, you have to look out for yourself and work with a competent health care insurance agent who can help you cut some corners.
Richard Cantu is with Texas Health and Life, a Texas health insurance and Texas life insurance agency in Texas. To learn more, visit Texashealthandlife.com.
