{"id":595,"date":"2016-11-18T00:06:00","date_gmt":"2016-11-18T00:06:00","guid":{"rendered":"https:\/\/simplyinsuredblog.wordpress.com\/?p=595"},"modified":"2021-06-17T16:22:06","modified_gmt":"2021-06-17T16:22:06","slug":"four-medical-bills-where-health-insurance-matters-most","status":"publish","type":"post","link":"https:\/\/www.simplyinsured.com\/advice\/2016\/11\/18\/four-medical-bills-where-health-insurance-matters-most","title":{"rendered":"The Four Medical Bills Where Health Insurance Matters Most"},"content":{"rendered":"

Your health insurance covers a long list of potential medical expenses. How does your coverage stack up in the four areas that make the most difference in medical bills?<\/em><\/span><\/h2>\n

When it comes to health insurance, a health insurance plan is used to cover a large list of potential medical scenarios and expenses. For most bills, the amount you would pay out of pocket will not vary much from plan to plan.<\/p>\n

However, after looking at thousands of health insurance plans, we’ve found that there are four areas where having seemingly similar health insurance plans can result in dramatically different medical bills.  <\/span><\/p>\n

Based on our analysis, these 4 components of your health insurance plan are: <\/strong><\/p>\n

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  1. Brand Name Prescription Coverage<\/li>\n
  2. Emergency Room Coverage<\/li>\n
  3. Hospitalization Coverage<\/li>\n
  4. Health Savings Account (HSA) Eligibility<\/li>\n<\/ol>\n

    #1: Brand Name Prescription Coverage<\/h2>\n

    Brand name prescription coverage is a very important coverage area given the impact on both out of pocket costs and prescription availability.<\/p>\n

    Prescription Availability<\/h4>\n

    Whether or not a brand name prescription will be covered by an insurance carrier depends on if the brand is part of the insurance carrier’s prescription drug formulary, or a list of pre-approved prescriptions. If the prescription brand is not included in the formulary, you may be required to try an alternative brand or generic prescription.<\/p>\n

    Out of Pocket Prescription Costs<\/h4>\n

    The choice of insurance plan can also have a substantial impact on the costs you have to pay for prescriptions. The best plans with good brand name prescription coverage helps limit your out of pocket expense to a simple $30-50 copay, while a plan with poor coverage will require you to spend thousands of dollars out of pocket first before the copay kicks in. The critical difference is whether the insurance plans requires the deductible to be met before prescription drugs are covered under a copay.<\/p>\n

    For example:<\/strong><\/em><\/p>\n