Healthcare, Simplified: Choosing A Plan That Actually Covers Your Needs

Healthcare, Simplified: Choosing A Plan That Actually Covers Your Needs

No matter how much schooling you go through, when you reach adulthood, there are going to be some concepts that make absolutely no sense to you. What is tax withholding? Escrow? And the same goes for healthcare. Why did no one tell us about this stuff?

Whether your work provides coverage or you’re flying solo, reaching the age where you need to make healthcare decisions can be daunting. Is that short-term plan going to skimp on coverage and leave you paying out-of-pocket? Know what we’re saying? Probably not — that’s why UPMC Health Plan and Fitt have broken it down for you.

Healthcare, simplified

Let’s begin with the most logical starting place: Open Enrollment. This is the period of time when you are allowed to choose a new health plan. So, make sure you’re set up for 2019 by applying November 1 through December 15, 2018.

Next, when you’re selecting a plan, you need to take the Deductible into consideration. The deductible is the amount you must pay for covered health services before your health plan kicks in. That means if your deductible is $1,000, that first grand is on you before your insurance picks up the tab.

We’ll leave you with the simplest concept to understand: Premium. This is basically your monthly bill for having coverage. Your high school economics class will tell you that you should go for the lowest option, but being that you do your own grocery shopping now, you probably know that cheaper is not always better.

You Need Everyday Coverage

Everyday coverage shouldn’t come with an asterisk, and that’s what often accompanies something called short-term, limited-duration insurance (STLDI). That’s a long phrase for health coverage that has an initial term of less than 12 months. While the lower premium for this type of short-term plan looks good on paper, you could be left paying out-of-pocket costs for something as little as a routine doctor’s visit.

You’ll also find that there’s a lot of fine print and limitations that you may not initially be aware of. For instance, you can be denied coverage or end up paying a higher premium if you have a pre-existing condition, you could end up dropping a fortune on your medications, and Essential Health Benefits like maternity care, emergency services, and mental health and substance use disorders aren’t part of the deal.

Bottom line: it’s a Band-Aid of a health plan, and if you don’t know your coverage from your co-payments, you could be put in a bad spot.

Our advice is also UPMC Health Plan’s advice: you have to pay for coverage no matter your situation, so choosing a plan that actually covers your needs, plus unforeseen illnesses or accidents, is the adult thing to do.

When you’re ready—preferably during that “Open Enrollment” period you just learned about—UPMC Health Plan will lay out your options reaaaaal simple here.