5 Must-Know Facts About Health Insurance Policies 

Are you confused by the myriad of health insurance plans available in today’s market? Don’t worry, you’re not alone. With the constantly changing landscape of healthcare and new insurance policies being introduced regularly, it can be overwhelming to navigate through the options.  

Whether you’re a first-time buyer or looking to switch plans, these tips from our independent agents at McKnight & McKnight Insurance Solutions will provide you with the essential information you need to make an informed decision about your healthcare coverage. 

#1. Carrying Insurance is a Necessity  

#2. Demystifying Deductibles & Co-Payments 

#3. Your Network is Important  

#4. Costs for Prescriptions Vary 

#5. Some Insurance Companies Offer Free Services 

Let’s dive in!  

#1. Carrying Insurance is a Necessity  

Health insurance is not just an option; it is a necessity in today’s world. With the rising cost of medical treatments, having health insurance can protect you from financial hardships that could arise as a result of unexpected illnesses or accidents.  

Health insurance offers more than just financial security. It also promotes a proactive approach towards preventive care and early diagnosis.  

Many insurance plans cover: 

  • Routine check-ups 
  • Vaccinations 
  • Screenings for various conditions 

By using these services regularly, you can potentially catch any potential health issues before they become serious concerns. 

Furthermore, having health insurance gives you peace of mind knowing that you have access to timely medical assistance when needed. It allows you to focus on your recovery instead of stressing over how to pay for healthcare expenses. You can’t beat that peace of mind.  

#2. Demystifying Deductibles & Co-Payments 

Understanding health insurance policy terms can be like navigating a maze of jargon and confusing terminology. Three key terms that often come up in discussions about health insurance are deductibles, coinsurance, and copayments. 

  • Deductibles refer to the amount of money you need to pay out-of-pocket before your insurance begins to cover your medical expenses. Think of it as a threshold that you must cross before your insurance kicks in. The higher the deductible, the lower your monthly premium is likely to be, but keep in mind that you’ll have to bear more upfront costs if you require medical care. 
  • Coinsurance refers to the percentage of healthcare expenses that you will be responsible for after meeting your deductible. For example, if your plan has a 20% coinsurance rate, this means that you will pay 20% of the total cost of any covered services while the insurer takes care of covering the other 80%. It is important to note that coinsurance applies even after meeting your deductible. 
  • Copayments are fixed fees paid at each visit or service utilization. Unlike deductibles and coinsurance which are usually expressed as percentages or dollar amounts, copayments have set prices for specific services or medications. For example, an insurance plan may require a $30 copayment for a primary care office visit or $10 for generic prescriptions. 

#3. Your Network is Important  

Understanding your health insurance plan’s network is crucial. Your network consists of doctors, labs, imaging centers, hospitals, and providers that have agreed to provide services at a contracted or negotiated rate with your insurance company. 

Choosing providers within your network is essential because it can significantly impact your out-of-pocket costs.  

When you seek care from in-network providers, you typically pay lower copayments or coinsurance compared to out-of-network providers. 

While seeing an out-of-network provider may sometimes be necessary due to certain specialties or unique circumstances, being aware of which facilities and professionals are considered in-network can save you money and ensure seamless coordination of care within your health plan.  

#4. Costs for Prescriptions Vary 

For most insurance plans, the cost of prescriptions depends on several factors such as the tier level assigned to each drug and whether or not it has a generic alternative available.  

  • Generic drugs are typically the most affordable option as they contain the same active ingredients as their brand-name counterparts but come at a lower price point.  
  • Brand-name medications are often more expensive due to research and development costs associated with creating new drugs.  
  • Non-preferred drugs are usually less cost-effective options and are only prescribed when necessary alternatives have failed. 
  • Specialty medications are used to treat complex chronic illnesses and must be handled with extra care.  

Some plans may require copayments where you pay a fixed amount after satisfying your deductible or coinsurance where you share a percentage of the medication’s cost with your insurance provider. In some cases, especially for non-preferred drugs or those not covered by your plan, you may need to bear the full cost until reaching your annual deductible limit. 

Understanding these nuances can save you significant money while ensuring access to necessary medications under your insurance coverage. 

“As a retired insurance agent, I greatly appreciate Bob’s expertise. Always very thorough and knowledgeable. Very confident in his recommendations. Also, his system of setting up appointments is very convenient. Five stars all around!” 

-Marty A 

#5. Some Insurance Companies Offer Free Services 

Many people are unaware of the additional perks and free services that their insurance companies offer. Besides covering medical expenses, some health insurance providers also provide valuable resources for improving your overall health and well-being. These services can include: 

  • Weight loss help 
  • Assistance with quitting smoking 
  • Health condition management programs 

It’s worth noting that health insurance companies often offer discounts on gym or spa memberships, health coaching services, and perks that extend beyond physical health. Some insurance companies even provide discounts on mental wellness services like yoga classes or meditation workshops. Make sure you take advantage of these free services and discounts. You’re paying for their services after all!  

Read More > Can I Get Health Insurance Any Time of the Year? 

Helping You Stay Healthy & Happy  

If you need a new health insurance plan, you can trust the expertise and guidance of our team at McKnight & McKnight Insurance Solutions. We understand that navigating the world of health insurance can be overwhelming, but we are here to help make the process easier for you! 

Don’t hesitate to reach out to us today to get started. Your well-being is our priority, and we are dedicated to providing you with peace of mind when it comes to your healthcare coverage. 

Request Your Proposal Here

Are you ready to save time, aggravation, and money? The team at McKnight & McKnight Insurance Solutions is here and ready to make the process as painless as possible. We look forward to meeting you!

New Side Bar
Call Email Book Now Quotes

Request a quote now!