Beyond Health Insurance Basics: The 3 Essentials You Need to Know

Healthcare insurance isn’t a lighthearted topic that most people can discuss with any degree of certainty – other than it’s necessary and you can be penalized for not having it.

You’re aware if you have a copay for visits to the doctor and you know how much you have to pay for prescriptions that you get on a regular basis.

Beyond this rudimentary grasp, you probably aren’t confident about much more.

You’re not alone – it turns out that most people don’t have an in-depth understanding beyond the health insurance basics.

While federal healthcare laws state that information is to be presented to consumers in a way that is relatively simple to comprehend, that isn’t the case the majority of the time.

You may be surprised by how much you and other consumers like you don’t know about their coverage.

And if you don’t understand, how can you make the wisest financial choice or the one that best suits your needs and the needs of your family?  

Some recent studies exemplify this disparity.

The numbers

One study showed that only 14% of the subjects tested had a fundamental knowledge of deductibles, copays, coinsurance, and paying out-of-pocket.

One of the most telling parts of the study was that each randomly chosen subject was a person with healthcare coverage.

These consumers, just like you, are spending their hard-earned financial resources and don’t know if what they’re getting in return is the most economical choice or if the coverage they’re paying for is more than they need or not enough.

In another study, the only subjects who were able to successfully choose an affordable healthcare plan were those who had an MBA.

They chose correctly 73% of the time, as compared to ordinary consumers, who only made the right choice 21% of the time.

These are two simple studies, but the ramifications of the results are far-reaching.

If you don’t understand the health insurance basics, you’ll have much more difficulty making a choice that is the best one for you and your family. You need some help.

How to better understand health insurance basics

Healthcare experts are called “experts” for a reason.

They know the insurance industry inside and out and their job is to help you in making the decisions for your healthcare insurance coverage based on your personal situation.

Going it alone isn’t a good idea when there’s so much at stake.

Here’s why you need to take advantage of the skills an experienced advisor can offer.

1. The pros understand the fine print

You probably haven’t read the fine print on your health insurance policy and, even if you did, you likely wouldn’t understand it.

Healthcare insurance advisors are inundated with the nitty-gritty of the confusing language of policies like yours all day, every day.

Not only do they get it, they know how to make you get it too. They can explain exactly what you’re getting and why you need it. This would be nearly impossible to tackle on your own.

2. They will advocate for you

Even after you’ve passed the policy purchasing process, the advisor you worked with will advocate for you if necessary.

The health insurance agent is ready to help you when it’s time to re-enroll or you need to make changes.

Sometimes, situations arise in which there is a discrepancy between you and your provider.

Your healthcare expert will be able to mediate for you and get to the bottom of any issues.

Many times, consumers who attempt to rectify situations on their own are unsuccessful and can even end up paying out more money than they should.

3. They have access to a variety of carriers

An experienced advisor has information about various policies and carriers at his fingertips.

Because an agent works with so many different companies, he’s able to sift through all that’s out there in order to find the policies that are just right for you and your family.

No one would have the time and resources to research the amount of information that a skilled healthcare insurance advisor has easy access to.

Using healthcare knowledge to your advantage

The statistics show that most Americans don’t have an adequate enough understanding of  the health insurance basics to make the wisest choices for their own coverage.


Seeking the expertise of a seasoned advisor will benefit you and ensure you have the security you need.


In what areas do you need to beef up your knowledge of the health insurance basics?