How to shop for insurance...
Health insurance exists to protect you financially in case of major events. Make sure you purchase a comprehensive policy. Your past health history is never an indication of future events. Anyone can get involved in a car accident or be stricken with a disease. It also makes sense that as we get older more health problems are expected. One thing I cannot stress enough is to make sure you get a policy that will protect you financially against a catastrophic event.
Since I'm buying an individual policy, can I be cancelled or have my rate increased due to claims?
No. A federal HIPAA law prevents any insurance company from raising your rates or cancelling your policy due to claims or a change in health. This is not to say that health insurance companies cannot raise rates. They can raise rates based on age or for an entire class of policies, but no one can be singled out for an increase or cancellation simply because they file claims. Here is the direct link to the rules of cancellation regarding individual coverage:
What is the single most important piece of information I need to know before shopping for a plan?
It's absolutely imperative that you find out the "out-of-pocket maximum". Simply put, this is the plan stop-loss. Always ask your agent what the plans' out-of-pocket maximum is. If the plan does not have a maximum, you may want to continue shopping.
Know the plan deductibles.
Deductibles can be confusing since they can apply to more than one part of the plan. For example, prescription drugs can have one deductible and hospitalization can have a separate deductible. You need to find out from your agent what the deductibles are for all parts of the plan. You also want to find out if the deductible is per year or per occurrence.
Ask about co-insurance.
Co-insurance is the percentage of the bill you are responsible for. For example, a plan with 80/20 co-insurances means you would be responsible for 20% of the bill up to the out-of-pocket maximum.
Know the plan limitations.
Some plans limit doctors visits or prescription drugs. Ask your agent if the plan has any limitations regarding doctor visits, prescription drugs, or wellness. You will also want to know the policy maximum. You should have at least two million dollars of coverage.
Get it in writing.
When an agent tells you about the plan details make sure it's backed up in writing. If it's not in writing then it doesn't exist. This especially applies to "this sounds too good to be true" situations.
Dont' get pressured.
Purchasing a health insurance policy is a major decision. If you rush into the wrong policy you may not be able to change companies. You could have a change in health, which might make you ineligible for other insurance, therefore, trapping you with the policy you have. Before buying a policy ask yourslef a simple question: "In a major event is this the policy I would want to keep?"
Ask if it's a discount plan.
Beware of agents selling discount plans. There are cases where the agent may not directly state that it is not insurance. Simply ask the agent "Is this a discount plan of insurance?"
Ask if the policy is tied to an association. If so, what are the fees?
Always ask if the plan is tied to an association. Just because a plan is tied to an association does not mean you should not purchase it. Many plans offer valuable association benefits that are worth looking into. But ask if you are required to join the association. Ask about association fees and find out if there is an administrative fee.
Run through some scenarios.
a) If I broke my leg and went to the emergency room, what would I owe?
b) If I had a major heart attack and the bill was $60,000, what would I owe?
c) If I got sick, saw my doctor and got a prescription, what would I owe?
d) What if I need physical therapy?
WARNING: Failure of any agent to directly answer these questions is a warning sign.