What to consider when choosing health insurance and innovation in digital health.
When it comes to personal healthcare, one of the most prevalent issues in society is a patient deciding between utilizing lifesaving medication to keep them alive or paying a hefty medical insurance premium. Many assume that health insurance will be the answer to all healthcare needs. Still, in reality, health insurance companies have loopholes and hidden doors that patients are unaware of until the day comes that they need coverage. Patients often question how they can get the best health insurance since they aren’t aren’t experts in the field or familiar with the subject matter. An answer can usually be found through rigorous research, yet still everyone is of different ages and have their own medical needs or specific care preferences. So, how can you tell if your research has led you to an excellent or lousy healthcare decision?
Common terminology that every patient should know, regardless of age, is a deductible and copayment. Now, a quick refresher on what each means is quite simple; your deductible is the amount you owe your healthcare service provider before your health insurance or plan even begins to pay them for said service. As for a copayment, that is the amount you pay as your share of the cost for said medical service. An example, think of this as your typical doctor’s visit. Copayments tend to be a fixed fee a patient pays, while deductibles can vary depending on the medical insurance provider a patient has selected. Usually, there is a third option that follows deductibles and copayments, known as coinsurance, and that is your share of the cost for the covered healthcare service. The insurance provider will calculate this as a percentage of the allowed amount for the service.
The final two keywords are premium vs. network. The premium would be an amount you pay for the health insurance or plan each month, while the network is the doctors, hospitals, and suppliers your health insurer has contracted with to deliver health services to members. Suppose patients ignore the network of doctors, hospitals, or suppliers they utilize. In that case, they are seriously jeopardizing whether or not they have coverage, which most likely will result in it not being covered and a not-so-loving bill. Once that bill comes, there is no escaping it either. All this terminology can seem confusing or just be hard to remember as a patient, but there are a few fundamental rules you should remember.
As previously stated, patients MUST read their plan completely and understand it entirely before selecting it. Please make sure not to be fearful and ask as many questions to your service providers and insurance companies before it is too late since your health and well-being are ultimately at risk behind this decision-making. Nonetheless, when selecting a plan, it’s important to remember that patients who use a lot of medical care should use a plan with a higher premium as it could be an overall better deal. Higher premiums tend to have lower deductibles, copayments, coinsurance, or other out-of-pocket limits that patients could run into—reiterating that rather than risk medical coverage, do your research and select a plan with the best coverage. Patients might not need it now, but one day when you need the coverage, it will cost you significantly more.
There are innovative care models like Direct Primary Care and Liton MD which bring a more affordable subscription model. Innovative digital Health services like Liton MD offer a concierge primary Physician and covers up to 750 formulary medication at $2/day.