The latest from Polygon: What if you don’t have the right health insurance?
What if your car breaks down?
What about the weather?
And what if you can’t afford a trip to the doctor?
If you’re like most Americans, your insurance doesn’t cover all of those things, and some insurance plans will only cover certain types of medical treatment.
The good news is that if you’re a high-risk population for heart disease and diabetes, you can avoid them entirely with an affordable plan.
Here are 10 things to know about getting the best coverage you can for your medical needs.1.
Your medical bills won’t go down When you’re covered under a plan, you pay a percentage of your medical bills.
The bigger your deductible, the more your premiums will go down.
This can be as low as 0.5% for plans that offer a high deductible.
That’s more than enough to cover all the things you need to see and to pay for treatment.
If you don’ have a high out-of-pocket limit, your deductible will be less than what you’re paying now.
If your plan doesn’t have a low deductible, your plan will still cover a small portion of your costs, but the percentage is lower.2.
You’re not getting all the treatment you need with the same careYou’re not going to get all the care you need if you have high medical bills, says Peter Tresca, senior vice president of health care and health finance at health insurer Cigna.
“The reality is that people will pay for a lot more out of pocket if they don’t get the care they need,” he says.
“If you don, you’re going to be stuck with a higher deductible and a higher premium.”
For example, if you need surgery to repair a heart defect, you’ll have to pay $2,500 out of your $2.5 million deductible.
If that’s the case, your insurer may be able to negotiate down the cost by up to $200.3.
You won’t be covered for everything your insurance coversSo even if your deductible isn’t the biggest it’s likely to be, your premium may not cover all your care, Trescan says.
For example: if you had a car accident, your car’s manufacturer may not be able or willing to cover the full cost of repairs.
In that case, you may have to go to the hospital and pay for all the treatments, such as surgery and other treatment that may be covered by your insurer.
That means that if your insurer only covers one type of treatment, your coverage will be lower than if you were covered for all.4.
You may not get the same type of care in different locationsIf your insurer is paying for all of your treatment in one location, you might not be covered if your coverage varies by location, Thesca says.
You’ll have lower premiums for your doctor’s office and for hospital outpatient care, but you’ll also pay more for other care, such for prescription drugs, in-home visits and physical therapy.5.
You can’t buy a single plan that covers all your medical costsAt this point, you could end up paying for everything you need for a particular type of medical procedure, Tlesca says, but not all of it.
If the doctor says you need X amount of care, and you can get X, then your insurer will pay X out of their money.
If they can’t, you’d have to find a plan that doesn’t include all of the costs.
If it doesn’t, the amount of money you’d be charged could be higher than the amount you’re entitled to.6.
You might not get enough care for your diseaseIf you have chronic conditions like heart disease or diabetes, and your doctor suggests you see a specialist, it might be best to seek out a second opinion.
If doctors don’t recommend your second opinion, you have options: You can switch plans with another insurance company, or you can ask for a third opinion.
Your deductible may increase, so you’ll need to pay more out- of pocket for care that was covered.7.
Your coverage won’t protect you if your insurance plan is discontinuedYou may not have the same coverage as before.
Some plans, like those from Cignas, offer a higher deductibles for certain types and services.
If this happens, you won’t get what you need from your insurance provider or from the hospital or clinic.
Trescas says these changes may be happening for a number of reasons, including new technology or the rise of more specialized services.
“When you have a new service or new technology, you want to get a better deal,” he said.
“But when it comes to the level of coverage and the cost, it’s just not going out there.”8.
You don’t know what the best option is for your health insuranceIn many cases, you don`t know what your best insurance plan will be until you