What does a good health plan cost?

Let’s be clear what you’re looking for. You want a health insurance plan with the most flexibility, the widest coverage possible and the most benefits for the lowest premium. OK, so this is everyone’s dream, but you can go a long way to making it real if you approach it in the right way. For these purposes, I’m assuming you’ve already put in the work to get online quotes from as many insurance companies as possible. You need to know what the average premium rates are for each type of policy before you start direct negotiations. Yes, sorry about that: you really do have to talk to the companies about this because the detail of what is on offer takes too long to explore in writing.

The first key issue to clarify is the real cost if you have to make a claim. It’s not enough to look at the monthly premium instalment and decide it’s affordable. There are other costs that can be financially overwhelming if you’re not prepared. There are three words you need to learn:
1. Co-payments
In HMO and similar plans, these are the amounts you’ll have to pay every time you see a health insurance provider, have lab work done, go for prescription drugs, etc.
2. Deductibles
In most indemnity plans, you agree in advance to pay the specified amounts before the insurance company has to pay on any claim. Watch the way the terms are worded. Some policies set an annual maximum. Others require the deductible to be paid on every claim no matter how many (or few) claims you make. The larger the deductible you accept, the greater the discounts you receive.
3. Coinsurance
As if the payment of the deductibles was not bad enough, you can agree to pay an additional percentage of the medical costs. In effect, you are self-insuring. The idea is that you invest any savings on the premiums against the risk you have to make a claim.

Once you’ve put real numbers on to the co-payments, deductibles and coinsurance percentages, you can move on to the reality of the cover provided. Be very careful if you have a medical problem when you apply. This must be disclosed. Ask about waiting periods, whether you can continue seeing your regular physicians, and so on. Then you need to explore adding others to the plan, i.e. your partner and any children or other close relatives. Only through this kind of detailed discussion can you find out whether you can get the cover you really need.