But, beyond that, plans that ask you to pay out of pocket for first visits and prescriptions tend to be cheaper than plans that make you pay a portion of each bill. If you have savings or the ability to borrow money easily, it often pays to purchase a cheaper plan with a higher deductible. If you don’t get sick, you’ll save money. And if you do, you’ll have the financial cushion to pay a greater share of health care costs that year.
If you don’t have savings or the ability to borrow money, you may prefer to use insurance to smooth out your costs over the year. Buying a more comprehensive plan will cost you more each month, but you might decide it’s worth it to avoid the financial consequences of an unexpected bill.
How much will you pay to have the choice?
Some of the cheapest plans on the Obamacare market are plans that only cover a limited set of doctors and hospitals. Plans, called close networks, can be a bargain. But buying one may mean you have to ditch a doctor you already know well, or you’ll be walked away from a hospital you prefer because it’s deemed too expensive to use. These are tough trade-offs, and different people will feel differently about what’s important to them.
If you have many known health conditions and have strong relationships with doctors and hospitals, you’ll need to search network listings for plans to make sure you can continue to receive the care you want. The same is true if you have a particular set of medications. This may require further investigation, as network directories are often confusing and outdated. If there are doctors you can’t live without, call to make sure they’re covered.
You may be able to get a more affordable plan if you’re willing to use a plan that covers a particular set of doctors and hospitals. Plans that do this are often called HMOs or EPOs — although other types of plans are also increasingly limiting their list of covered doctors.
Even some people who don’t currently have a doctor might want a wide choice if they get sick. Plans that allow patients to get coverage for so-called out-of-network providers, usually called PPOs, tend to be more expensive. Check the plan summary to see what these plans will pay for a doctor who is “out of network”.
How about the quality?
Ideally, health insurers would compete on the basis of customer service, not just price. But experts I spoke to said there’s still no good way to compare plans based on quality. So if you’ve found a plan that’s a good deal, has a deductible you can afford, and covers the doctors you care about, it’s probably a smart choice. There’s always a chance you’ll end up filling out boring paperwork or being stuck for hours trying to make an appointment. But that might have been true with another insurance company too. .