Managing a chronic condition can require more frequent checkups, medication, and supplies – and all these costs can really add up. So it's important to choose a health insurance plan that will help keep your monthly costs as low as possible. The key is estimating how much care you need and comparing the all-in cost (the monthly premium + what you pay for care) of the different plans you’re considering. Here's how to do it.
Choosing the right plan to manage a chronic condition
Say, for example, you have a chronic condition like high blood pressure. Your cardiologist wants to see you every three months, and you have three monthly prescriptions. You look up your cardiologist and see she's in our network. Your medications are covered by our formulary and listed as generic drugs. It looks like Oscar could be a good fit for you, but which plan has the lowest all-in cost?
Let's say the plan with the lowest premium is a Bronze plan that costs $342 a month with a $6,850 deductible. You'd pay your monthly premium plus Oscar's negotiated rate for any care you get until you've spent $6,850. Given the cost of your doctor's visits, medication, and lab tests, you might decide to look at a plan that will pay for more of your care.
Next, you take a look at our Silver Simple plan. It costs a little bit more every month, but it has copays for specialist visits and generic drugs. So even before you've met your deductible, you're just paying a copay for your cardiologist visits and medication. All-in, your costs on this plan are actually lower than they would have been on the Bronze plan, even though the Silver plan has a higher premium.
As a general rule, the more you pay up front in monthly premiums, the lower your deductible, so your plan starts to cover your care sooner. If you have a chronic condition, plans with affordable copays and/or lower deductibles can help you save money in the long run.
Don't forget to check that the insurance company has your doctor in their network and covers the medication and medical supplies you need. You should also look at the preventive and wellness services offered with your health plan. These can be critical to helping you catch issues early.
Once you’ve selected your plan, make sure your plan stays active all year by paying your monthly premiums on time. One easy way to do this is to sign up for auto-pay. If you lose your coverage because you forget to pay your bill, you may not be able to sign up again until the next Open Enrollment, which could be months away.