Choosing Health Insurance

Knowing what you want, and working on what you can afford for a budget will help you a lot in your efforts to acquire coverage for your health concerns. Remember that you will not be able to acquire all your needs and wants from just one provider – almost all organizations that provide insurance for health coverage during emergencies and procedural requests of medical practitioners who will check your health issues, will have limitations (read the fine print of the pro-forma policy, if you can get hold of one).

Remember, too, that these organizations are almost always in service primarily to earn some good profit for their operations. They need to continue churning out services, and delivering their promises to many clients, even when most of their clients have come and gone. More than anything else, you need to always remember that the whole health care industry is a humongous  business, such that it includes players from the health insurance sub-industry – nothing bad with this set-up. You just have to possess an open mind in dealing with anyone from the business. When you choose health insurance, you will have to:

1)   shop around for providers that are known to people you genuinely trust. Make sure that someone from your own network whom you believe and trust has made use of the organization that you are considering to purchase from for your health coverage.

2)    define and be clear about your medical needs that connect strongly with your health issues (that you may not be sure about now). Write them down, even on a small sheet of paper, so that you’ll have a reminder on what exactly your issues are, so that when you come to talking with the sales person of these health insurance organizations, you’ll focus more on the issues that concern you, and not that of the organization offering you coverage.

3)    check and know more about the organization that offers you coverage. Make sure they’re strongly funded, and well managed by leaders and managers whose very reputations are at stake by being involved in this kind of business. Make sure, too, that you can claim from your state insurance commission, in case something foul happens – you can do this by checking if the organization is recognized by the authorized government office where you now live.

4)    it makes sense to join organizations yourself where you will have better opportunities to acquire health coverage. As part of a group, you can leverage in terms of prices, package inclusions, and quality of service.

5)    if you’re purchasing health coverage on your own, you’ll have less leverage when you deal with health insurance organizations. But despite this, you can still acquire coverage, as long as you’re willing to pay and haggle to reduce the price. And also, you may consider buying coverage to include other members of your family, which will actually help reduce premium costs.

6)    just like talking with sales people from other organizations, be open minded with meeting up with sales people offering your health insurance. Write down, compare and study their prices and promised services, and highlight the pros and cons – and decide after a deadline that you set for yourself when you purchase coverage for health. Unless you’re very happy with what you’re purchasing, keep your cards to yourself (as they say).

7)    remember that it’s apparently a demand-driven business with so much unmet requirements (and unsatisfied clients whose woes you always hear about everywhere) for health care services, so that we see now the presence of so many players offering health-related services. This situation allows health insurance organizations to continue to be in business.

8)    know the quality of services you will get for your health coverage will depend a lot on the expertise, wisdom, and extent of service of the team members of the actual health care group that will handle your case when you need to avail of the services. You will have to know if there will be “gatekeepers” who will have a say in giving you the go signal whether you can proceed on every step of the way, when you start claiming your benefits (insurance companies almost always like to keep tab of the costs, remember this!).

9)    be aware there are health maintenance organizations (HMO), and health insurance organizations. HMO almost always promise to deliver health care services with certain limits and as managed by lead medical practitioners, and they’re usually localized in specific geographical locations. Health insurance organizations will almost always deliver your benefits, depending on what’s written in the policy, anywhere, subject to limitations such as the deductible (think of it just like your own policy for car insurance). There are even strange mixtures of the two for certain companies, depending on the opportunities seen by these organizations in the market (that includes you). Depending on your needs, budget, and location, you can decide which one will fit your needs.

10)    accept and learn facts about what will be actually covered by the insurance. Usually, diseases that you now have will not be covered, or even those diseases that you are prone to have (by virtue of genetics, age, gender, lifestyles, and other factors).

One tip coming from someone who belongs to a family whose members include medical doctors, medical technologists, pharmacists, nurses, you may want to seriously consider investing, if you see the opportunity, on businesses directly related to health care. This includes hospitals, care homes (for the aged and disabled), clinics, group practice by practitioners who joined together to run medical facilities, nursing and other health care schools. Study their structures, and learn if you may be able to avail of health care services if you invest in them now. They may come very handy when you need them in due time.

Or better yet, invest your time and valuable resources in keeping yourself fit and healthy, so you won’t have much unfounded concerns regarding health insurance. It’s very much driven by the fear factor – you’ll be able to manage the fear by taking charge of managing your health issues now.