Good Neighbor Insurance provides international travel medical insurance as well as Arizona medical insurance. Here are some things to consider when purchasing a U.S. domestic ACA (affordable care act) medical insurance plan.
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Don’t be penny wise and pound foolish:
Most importantly don’t pick a plan based solely on low premiums. As the saying goes “there’s no free lunch.” This is especially true with health insurance.
There are a lot of things to choose from. You can pay for your healthcare up front, in the form of a higher premium, or later, in the form of a higher co-payment, a bigger deductible, or both. Which option you chose should be based upon your personal situation and preferences. Neither is inherently better.
If you’re in good health and have good financial reserves, you might save money with a lower premium and higher cost-sharing. However if you have ongoing medical needs, you might do better with a higher premium and lower cost-sharing. Of course, there’s more risk if you opt for a plan with a very high deductible and co-pay and then can’t afford your share of expenses if you do happen to get sick.
One strong benefit of the Affordable Care Act law is that plans sold to individuals can’t impose more than $6,350 in annual cost-sharing in 2014, no matter how low the premiums. Before the Affordable Care Act it was not uncommon for plans to have deductibles of $10,000 or higher.
Going out of network:
One of the strongest features of a preferred provider organization (PPO) is that you can opt to get your care from doctors or hospitals that don’t participate in the plan’s network.
However the fine print can cost you. For instance, if your plan says it will pay just 50 percent of the cost of out-of-network care (compared with, say, 80 percent for in-network care), it will pay the percentage of what it determines is a “reasonable” price for the service—not 500 percent of whatever the doctor decides to charge. So if the fee is $2,000 and the insurance company decides that the fair price is $1,000, it will reimburse you only $500, leaving you having to pay for the other $1,500.
The way around this of course is to avoid going out of network, except when you absolutely can’t find an in-network provider. The only time that won’t work is when you receive non-network care involuntarily, such as during a trip to an emergency room of an in-network hospital where the doctor caring for you isn’t in the network, or when you have surgery and the anesthesiologist doesn’t participate in your plan.
Strictly speaking, you have no legal recourse but to pay those bills. However in practice, polite but persistent complaints to your insurer and the provider can sometimes in reducing the price.
Speaking of saving money, here’s another great way to avoid having to pay more for your current plan than is absolutely necessary.
If you are traveling outside the U.S. and doing some cool sports like scuba diving or hiking check out our travel medical plans that cover these types of sports insurance at http://www.adventuresportsinsurance.com/. For U.S. Arizona health insurance check us out at https://www.gninsurance.com/