What is the optimal time to devote to choosing a health insurance to plan? Health insurance is complicated, but most people, no matter how educated, turn out to be bad at making that choice. It’s confusing even for people who understand all the terms, such as deductible and copayment, according to a report by the Kaiser Family Foundation.
Not surprisingly, most people are hesitant to spend a lot of time choosing a healthcare plan. A survey by Aflac revealed that 57% spent less than 30 minutes on this important decision. Why? It may be because 90% of employees are simply sticking with what they have, choosing the same plan as last year.
However, this may be a mistake, as your employer’s offers – and the plans themselves – may have changed, and you could be missing out on a better choice for you and your family if you just stick with your old plan.
Key points to remember
- Choosing a health insurance plan can be daunting, with several options and levels of coverage available.
- Here we compare plans from Aetna and Cigna Preferred Provider Organization (PPO) as an example of what to look for when choosing your own health insurance plan.
- A combination of objective factors such as a state’s rank or score, as well as subjective factors such as recommendations from a friend or past experience, should be used.
Cigna vs. Aetna
As examples, we use Aetna and Cigna health insurance Preferred Provider Organization Plans (OPPs) offered by employers. The details of these companies vary by employer. But the tips for comparing plans could help you make your own decisions, whether among the plans offered by your company or the policies offered in the individual market through the Affordable Care Act (ACA) Health insurance marketplace/exchange on HealthCare.gov.
Explore your insurance options
The first step is to review your choices. You are likely to have a number of plans to choose from. For example, federal government employees who live in New York City have a mind-blowing number of plan choices — over 25. And in many parts of the country, there are plenty of choices on HealthCare.gov.
Either way, it pays to check annually to see if a newly available or expanded plan is available to you.
Consider the company
Both Aetna and Cigna insure large numbers of people and rank in the top 10 for size. Although a large health insurance company is not necessarily better, it is likely that a large one will have a good number of doctors to choose from in your network of providers, and you will also be able to find people you know who have had local experience with the plans offered to you.
Employees who periodically travel or work abroad may find Cigna Global Provider suitable for them due to its international medical insurance policies.
One distinction is that Aetna is a US-centric company, offering medical insurance through employers and in the individual market. Cigna is a global health insurance provider for employers in more than 30 countries, according to its website. If you work overseas or travel extensively, you will find that Cigna offers a number of international medical insurance policies.
Check the ranking of plans in your state
Rankings of health insurance plans based on consumer satisfaction and other factors have become easy to access and use. The nonprofit National Committee for Quality Assurance (NCQA) annually creates detailed quality rankings of PPOs and health maintenance organizations (HMO) available in every state.
If your choice is between the Aetna and Cigna OPPs, the 2019-2020 rankings (the most recent available) reveal that both insurance companies are generally well regarded by consumers. Their scores on a scale of one to five are identical in Pennsylvania, at 3.5. But in Vermont, the Cigna plan scores a 3.5 in consumer satisfaction while Aetna only scores a 3.0.
You can dig deeper into each, using the comparison tool to hone in on the plans you’re considering and see how consumers rate them on issues like getting care quickly and quality of primary care physicians. .
In Vermont, Aetna places great emphasis on getting care quickly, but falls short of primary care physician quality. Cigna also places a premium on getting care quickly and a little better on the quality of primary care physicians.
Consider what is important to your family
Ranking details can be important. If you’re considering expanding your family, check the company’s prenatal and postpartum care assessments. If a family member has asthma, check the plan’s rating for asthma control and asthma medication management.
It may not be possible to check off all the boxes on your family’s list of potential medical needs, but you should try to cover as many as possible.
Ask around you
If you have doctors you like, you’ll want to check with their offices before switching insurance plans. Many doctors and hospitals take multiple plans, so this may not be a problem. If you’re looking for a new doctor, don’t pick randomly from the insurer’s directory of practitioners.
Your co-workers, neighbors, and healthcare professionals can also give you helpful advice on doctors in your area. It may take some time to gather a list of doctors and sort through it, but once you’ve done that, you can call their office to find out what insurance plans they accept.
Asking around is also a good idea when considering a plan. Ask others about their experience with physicians accepting the plan, how out-of-pocket costs increase, and if they’ve had any issues with filing claims or denying services. These factors may vary by locale, so a colleague who lives in your area will be better informed.
Another tip: if your routine care involves testing or seeing specialists, make sure everyone involved in your care is on your insurance plan. Using in-network doctors and services will reduce your costs.
How can I choose the best health insurance company?
Several factors go into choosing a health plan that meets your needs: cost, choice of providers, user reviews, and other costs such as deductibles, coinsurance, and co-payments. Start by making a list of the doctors you want to see and check the plan’s coverage to see if they are part of the network. Then find an online calculator that can help you compare total costs between plans.
What is the Affordable Care Act?
The Affordable Care Act (ACA), also known as Obamacare, created to extend medical coverage to millions of uninsured Americans, was signed into law in March 2010. The law expanded Medicaid eligibility, launched the health insurance market, prevented insurance companies from denying coverage due to pre-existing conditions, and required plans to cover a list of essential health benefits. Low-income families are eligible for subsidies for market-purchased coverage.
What is HealthCare.gov?
HealthCare.gov is a federal government website operated by the United States Medicare and Medicaid Service Centers (CMS). It includes information about the Federal Patient Protection and Affordable Care Act, as well as the federal government health insurance market.
Objective sources, such as insurance plan rankings, as well as subjective sources, such as the first-hand experience of colleagues, are both helpful when choosing a plan.
Rankings tell you how a plan ranks with many of its customers, but valuable information can also be found among colleagues, friends, and healthcare professionals who have had experience with a particular plan from your choices.