Optimize Your Health Insurance Plan

Expert advice on how to get the best insurance plan.
Q: It’s open enrollment season for health insurance. What should I compare policies on to make sure I get the best one for the price?

A: Generally, you want to look at price, coverage, and ease of use. Clearly, affordability should weigh heavily in your decision, but don’t let that be the sole criteria. If you have a preferred doctor, make sure he or she accepts the plan you’re considering. Also, look at the prescription drug costs in the plan, the deductible you have to pay before benefits kick in, and the overall amount you can be expected to shell out in any given year.

If you’re in good health and single, you can save money by picking a low-cost, high-deductible plan that will cover you mainly for major procedures. However, if you go to the doctor a lot or have kids, don’t make the mistake of picking a cheap policy only to later discover that it only covers major injuries or catastrophic illnesses.

On the coverage front, find out what services and procedures are included—as well as which treatments are excluded. Then, figure out how you would fare in a typical year, based on your expected use of benefits, the premiums, co-pays, and prescription drugs you may need. For instance, if you take specific medications, you might choose a plan with higher premiums if the drug costs were low enough to offset it.

Finally, check how easy it is for you to access benefits: How do you submit claims? Is phone or online assistance readily available? And what’s the process for seeing specialists or consulting doctors of your choice? Weigh all three of these areas—cost, coverage, and ease of use—on what your likely medical needs will be for the upcoming year, then go with the plan that has the best fit.