Insurance Choices Darren Harris November 2022

3 Tips to Picking The Right Insurance Plan for You

Originally published in the Williamson Herald

Open enrollment season is here—and navigating your insurance choices can be a confusing process, but it doesn’t have to be. Here are a few tips to help you make the best decision for your healthcare.

1. Know Who’s In Your Corner

Whether you’re considering healthcare coverage from your employer or going out on your own, it’s important to research all your options. While it might seem easier to simply select the same plan you chose last year, take the time to consider the plan’s network of providers to ensure that it includes the physicians, specialists and hospitals that you trust. Most insurance providers negotiate contracts with the providers within their network every two to three years, so networks do change and shift. If you want high-quality medical care that’s close to home from providers you know and trust—like the specialists at Bone and Joint Institute of Tennessee—pay close attention to each plan’s network.

Quick Tip: In-network medical providers will be listed in the plan or on the provider’s website. Make sure your preferred, trusted, local physicians, specialists, and hospitals are included.

2. Do The Math

Rather than simply picking the plan with the lowest premium, it’s best to anticipate your medical needs over the next year and estimate what your out-of-pocket expense might be for each plan you’re considering. That estimate should include the deductible, the amount of the total bill you’re responsible for before insurance pays, as well as any copayments, the fixed fee you’ll need to pay for each visit. Note that copayments can be higher for certain types of specialists or care, such as emergency room visits.

Terms To Know: High-Deductible Health Insurance Plan vs. PPO – As the name implies, high-deductible plans carry a higher deductible and offer lower premiums. They’re not the best choice if you need medical care frequently. PPO (preferred provider organization) plans offer higher premiums and lower out-of-pocket costs. This type of plan may be a good fit if you visit the doctor frequently.

HSA – If you select a high-deductible plan, you’re eligible to contribute to a health savings account (HSA). This lets you set aside money before taxes for qualified medical expenses such as deductibles and copayments.

3. Do Your Homework When It Comes To Medicare Advantage Plans

These types of plans are flooding the market in Middle Tennessee but are sometimes being sold before a provider network is in place. The lower premiums sound good, but without a local network of trusted providers, no one can treat you. In addition, some networks within these types of plans are so narrow, you may be forced to seek medical care outside of your community. Take it from me: saving a little on your premium each month can cost you more in the long run!

Quick Tip: When it comes to Medicare Advantage Plans, it’s best to consult a broker who understands the different policies and can explain them to you.

Whatever insurance plan you select, make sure you’re getting the quality care you deserve from providers you trust—like the specialists at Bone and Joint Institute. Situated just off interstate 65 in Franklin, Bone and Joint Institute offers state-of-the-art technology and a superior patient experience close to home. For more information or to schedule a consultation with a Bone and Joint Institute physician, visit www.BoneandJointTN.org.  

Darren Harris is the chief executive officer of Bone and Joint Institute of Tennessee. He oversees the day-to-day operations and strategic planning, with a focus on broadening the practice’s regional footprint.