MoneyInDepthHealth Insurance


Basic Medical Services You Want Covered

You probably already have some idea about which services you'd like your medical insurance to cover. Even if your list of requirements is short, it's best not to assume that all policies will cover it.

Use this short guide to assess which benefits are the most important to you.


This page:

  • Lists the services usually covered under medical insurance

  • Describes some additional extra health care services

  • Lists a couple of "rules of thumb" for choosing a health care plan


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The basic health care services

The most important factor, and the first you need to consider when it comes to determining which health insurance policy to purchase is the type of policy choose. Indemnity, HMO, PPO and POS medical insurance plans all have different priorities when it comes to how your health care is viewed and, therefore, treated. Some important topics that differ from one type of plan to another include your:

  • Doctor visits
  • Preventative care
  • Diagnostic tests
  • Hospital
  • Extended care
  • Emergency Treatment
  • Prescription drugs
  • Home health care

A really good medical insurance policy will include all these critical areas of coverage. However, a really good medical insurance policy is also really expensive. You will probably need to prioritize your health care to get what you need and want in a health insurance policy, without paying for coverage that is unnecessary for your needs.

An example: A typical fee-for-service (indemnity) plan will be relatively comprehensive except for prescription drugs and preventative care coverage. This is ideal for someone who values the security of extensive coverage over the elimination of routine costs, like doctor visits.

If a plan makes up for its lack of coverage in one area by covering services you find essential to your health care, it may be wise to live with this particular deficiency in the policy. Our health plan guide will give you more help with choosing between the different policy types.

Additional health care benefits

Depending on how much you want to pay or what your family health history is, you might want to cover other, less common areas medical attention in your medical insurance coverage. Some of these other coverage areas can include:


  • Dental Insurance
  • Vision Care
  • Care by Specialists
  • Care for Mental Health
  • Services for Drug/Alcohol Abuse
  • Family Planning Services, OB-GYN
  • Chronic Disease Care
  • Physical Therapy
  • Nursing Home and Hospice Care
  • Chiropractic Care
  • Maternity Care
  • Well Baby Care (immunizations, etc.)

One last protection

One additional policy provision for your protection is the "out-of-pocket maximum". This limits the total amount per year you'll have to pay before your medical insurance company compensates you for 100% of your health care costs. This protection is especially important in case of serious illness.


Sidebar
The out-of-pocket cap is something that you should definitely keep in mind when searching for health plans in your area at eHealthInsurance or when contacting the health care pros at NetQuote.

When you are researching possible plans through these services, remember the out-of-pocket cap, and make sure that it is included in your quote.


Tips on choosing a medical insurance policy

You must decide which health care services you want covered by your medical insurance. Here are a few tips to keep in mind as you're making the decision.

Tip #1: Purchase a medical insurance policy with basic health care coverage.

A medical insurance policy that's lacking in any area of basic health care is not very valuable. The health care services most often used can be the ones for which you most need insurance.

Tip #2: Add health care services to your health insurance policy based on family health history.

After basic medical insurance, consider health care provisions that apply to common family ailments. If, for instance, your family has a history of back problems, add chiropractic care to your list of covered medical benefits.

Tip #3: Use your policy to plan for the future.

If having children is a priority, look for a policy that includes maternity and well-baby care.

You can usually add or remove health care benefits to an existing medical insurance policy by using what is known as an insurance rider. If you find a policy that's almost perfect, try and shape it into exactly what you want. Remember to ask your insurance representative about adding ore removing riders after the policy is in effect to tailor it your changing needs.


Next: The necessary expenses of a medical insurance policy.

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