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Home » health insurance » Acquiring Quality Health Coverage Shouldn’t Mean Acquiring a Splitting Headache

Acquiring Quality Health Coverage Shouldn’t Mean Acquiring a Splitting Headache

April 9, 2009

Too often searching for the appropriate health insurance coverage becomes an overwhelming and tedious endeavor, and as a result, finds itself on the back burner of tasks to complete. However, it does not have to be this way. Before you start shopping, consider the things that are important to you. Making a list or a chart of these items will help focus your search and ease the process of finding the right balance between cost and coverage.

One of the reasons searching for quality health insurance becomes overbearing is a lack of understanding of the terms involved. Here is a glossary of items that will be useful when analyzing different options:

- Copayment: a set fee for any service; i.e., visiting a doctor.
- Deductible: the amount one is responsible for upfront when one receives a major medical bill before the insurance company will begin contributing to medical expenses. The deductible does not necessarily have to be satisfied to utilize preventive services and copayments.
- Coinsurance: is cost sharing with the insurance company, and is typically an 80/20 split. After the deductible has been met the insurance company will pay 80% of any bill, and they will ask you to pay 20% up until a certain limit. Once this limit or stop loss has been met the insurance company will pay 100%.
- Out of Pocket Exposure: the total dollar amount an individual will be responsible for in the occurrence of a catastrophic event. Typically it is the combination of the deductible and coinsurance limit.

Having developed an understanding of these various terms will alleviate much of the headache when searching for the health insurance plan that is right for you. The next step is matching up the items on your list with the appropriate coverage. The number one item that will influence an individual’s monthly premium is the plan’s deductible; specifically, the higher the deductible the lower your monthly premiums. This is truly a personal preference. When reviewing your list or chart also consider how frequently you have utilized your coverage in the past. If you have used your coverage repeatedly lower deductibles are likely worth it, since medical attention is regularly required. If an individual sees the doctor less frequently, then perhaps a lower premium is better suited for them. Furthermore, one way to gain protection against a higher deductible plan at a low cost will be to incorporate an accident benefit rider in your plan. Whichever plan an individual decides on make sure that there are a number of doctors and hospitals in your area who participate under the plan’s network.


MyInsuranceExpert.com helps people throughout the United States acquire affordable insurance from A-rated carriers. By leveraging “Artie”, a crazy old guy who knows everything about insurance (actually a proprietary technology) licensed Advisors at MyInsuranceExpert.com find the best value for each client.

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