What are the most important factors consumers have to consider when it comes to the individual product?
The two most important factors are quality and service. For consumers, the key issues in buying health insurance revolve around affordability, qualification and benefits. First, you must take a look at what you can afford and are willing to pay. Once you make a clear determination of what you can afford, the next step is to look for health insurance that will give you and your family the best health coverage at that price.
How can people determine what health insurance plan is best for them?
The type of plan that would be best for a person will vary based on individual preference. One will have to examine not just the monthly premium but also other potential out-of-pocket costs. Some of these costs include the amount of the deductible, how much you would have to pay for co-pays for physician visits, as well as whether preventive care — such as flu shots and medical checkups — is paid for by the plan.
There are many tradeoffs involved with choosing a health insurance plan. If someone wants low premium payments, he or she has to understand that, while monthly payments will be low, out-of-pocket costs for office visits and health care services will most likely be higher. If you want to control costs, you can choose a plan that has a higher premium.
What other issues should consumers be aware of when choosing a plan?
Consumers also will want to know about cost sharing for drug coverage. As part of your plan, do you get a lower price for a generic as opposed to a brand-name drug? Will you be assessed a co-payment for services, or is there co-insurance, where you pay a percentage of the total cost? These are things that people might not have looked at as closely when they were covered by group plans.
Will brokers continue to have a role in individual plans?
The establishment of health care exchanges would seem to minimize the role of brokers, but there will probably still be consumers who would want to use a broker to help them navigate the complex parts of health insurance. It would be an individual’s choice.
Anthony Benevento is vice president, sales and marketing for UPMC Health Plan. Reach him at [email protected] or (412) 454-7826.
