What to Know When Shopping for Rochester Health Insurance

Below are some of the most common concerns when shopping for a Rochester health insurance plan.

Are Your Doctors in the Network – When you’re ready to purchase a Rochester Health Plan, it’s always best to ensure that your doctors are part of the insurance companies’ network. Otherwise, you won’t be covered for the care received and any additional care or medications and treatments that the doctor recommends won’t be covered as well. Some plans may offer what’s called out-of-network coverage, but those plans aren’t available to individuals.

Paying Less Each Month May Mean Higher Usage Costs – While your first impulse may be to save money and spend less on a health policy, keep in mind the golden rule, pay less now and pay more later.  If the monthly premium is less, then the cost of using the plan is going to be more.  For someone that doesn’t have any health issues, then perhaps choosing a less expensive plan is the right decision for you. However, if you’re someone that has health issues and uses prescriptions on a regular basis, then it’s best to take a health assessment.  Consider how often you’re seeing doctors and specialists, are you going to labs often? Do you take a good deal of costly medication?  You may find that in your case, spending more per month on a policy may save you money in the long run.

Health Insurance is a Contract – Health insurance is a two-party contract and with the implementation of the affordable care act, all individual contracts are renewed on January 1st. That means that you’re locked into that policy up to the end of the year. If your policy doesn’t really fit your needs, then you can’t make any changes to that policy if you had purchased it through the exchange. You do have the right to cancel your plan anytime, however you won’t be allowed to purchase an additional policy till the end of the year.  Yor may be able to find an off-exchange health plan in Monroe County, NY however it’s going to be a plan for a freelancer or someone that’s self-employed.

Insurance Types – When talking about types of health insurance, we’re usually describing how the network of providers works and what type of flexibility the plans have. While there are several plan types such as EPO PPO POS HMO, the one you’re going to be able to purchase as an individual in Monroe County is the HMO. Those are the most restrictive and only allow you to use network providers. The other types offer more freedom though they do come at a higher price. For those that travel often, if you have access to plans that have national provider networks, then you may want to consider spending the additional money.

Metal Levels -To make the buying and comparison process for Rochester medical insurance plans easier, the ACA created a classification process to easily distinguish between plan designs, known as metals. Each metal is being used to represent different plan levels. There are 4 types, bronze, silver, gold, and platinum. Just like the cost of these metals in the real world, the insurance that these metals represent reflects the quality of the health plan. The bronze is the least expensive monthly plan, which translates into higher usage cost. Platinum’s, which are the highest quality of metal, have the greatest monthly premium and will have little out of pocket cost when using the plan. As mentioned earlier, estimate your medical and prescription usage, and buy a plan that fits your needs.

Am I Fully Covered? – Rochester, just like every other location in the United States is protected by the ten essential health benefits that are mandated by law for insurance policies that are purchased through the exchange. They are a listing of guaranteed minimal coverages broken down into ten categories that each on exchange insurance plan needs to abide by. These is a possibility to purchase a plan that doesn’t have the ten essential benefits, however such plan is not approved for sale in New York State, such as faith-based plans and short-term health plans