What to consider when choosing a Montana plan

Things to consider when choosing a Montana health plan

Choosing a Montana health plan can feel overwhelming, especially if you are new to health insurance, but we can help! We have put together some of the factors that you should consider when shopping for 2018 health insurance coverage and choosing a Montana health plan that works for your wallet and your health care needs.

Questions to Ask When Choosing Montana Health Care Coverage

  • What are your ongoing health care needs (such as doctor visits, prescription drugs, or procedures)?
  • How much of a monthly premium would you like to pay or can afford?
  • How much can you afford to pay in order to see a doctor?
  • Is there a specific doctor, hospital, or medical provider that you would like to continue seeing?
  • Do you qualify for tax credits to offset the cost of premium or are you eligible to save on out-of-pocket costs? (If you are unsure, check out the calculator to see what you might qualify for.)

Finding The Coverage That Meets Your Health Care Needs

  • All of the plans on the Health Insurance Marketplace cover the same set of health care services including: outpatient care like doctor visits and outpatient surgery, emergency care, hospitalizations, laboratory services such as  X-rays, maternity and newborn care, mental health and substance use disorder care, prescription drugs, preventive services including immunizations and cancer screenings, and rehabilitative and habilitative care. However, each plan will have different out of pocket costs to access all of these services.
  • Each plan has a different provider network. An insurance provider network is the list of all the doctors, , hospitals, clinics and other health care providers who have signed special contracts with your insurance company. You will want to be sure your doctors and local hospital are in your plans’ network. If they aren’t, the insurance company will require that you pay a greater portion of the medical bill and it gets expensive fast! Seeing an out of network doctor could cost you up to four times as much.
  • The Montana Health Insurance Marketplace includes plans from three carriers: Blue Cross Blue Shield of Montana, the Montana Health Co-op, and PacificSource. However, each carrier sells many plans and each plan may have a different provider network. Some provider networks are very large and may cost you more, but there are also some limited network plans that may save you money if you are okay with seeing doctors in the smaller network.
  • In addition to provider networks, make sure that the health insurance plan covers any prescriptions drugs that you take. Again, each plan is different when it comes to prescription drugs so make sure that you check out the plan’s drug formulary to ensure your drugs are included and at a cost you can afford.
  • While all plans cover the same set of health care service, each plan requires a different level of cost-sharing to access these services. So, you not only need to find the coverage that meets your health needs, but also the coverage that fits your family budget.

Finding The Right Health Coverage At The Right Cost

When choosing a health plan, remember that what makes a plan affordable is all the costs that you’ll pay—not just the amount of the monthly premium. Deductibles, copayments, and co-insurance definitely add up!

All Marketplace Health Insurance plans generally cover the same set of health care services but, each plan requires a different amount of “cost-sharing” when you access these services. Cost-sharing is a general term that can refer to co-pays and co-insurance – the amount that you pay (in addition to your monthly insurance premium) when you see a doctor.

The Marketplace breaks insurance plans into metal tiers and in Montana we have gold, silver, and bronze plans. In general, a gold plan will have a higher premium, but lower out of pocket costs when you see a doctors. A bronze plan will have a lower premium, but you’ll probably have a to pay a larger share of the bill to see a doctor.

When selecting a health plan, it is important to not only factor in the cost of the monthly premium, but also any co-pay and co-insurance that you can expect.

Want more information? We can help! Check out our Health Insurance Basics and Get Covered pages. Our friends at www.MontanaHealthAnswers.com have a lot of information on their Health Insurance Buyer’s Guide. And you can find out more about choosing a health plan that is right for you.

Discuss Your Options With An Enrollment Assister

Perhaps the best way to understand your best Montana health plan option is to speak with an enrollment assister. To find an assister in your local community, please search for local help. Their help is always free and confidential.