It is really interesting to observe that most Americans are now attempting to live a healthy lifestyle. Gone are the days when people would binge on drinking and smoking. Together with different wellness programs, with the healthcare industry becoming highly agile and customer-friendly, Americans are leading a much healthier lifestyle.

There are many benefits of living a well-balanced and healthy lifestyle, like:

  • Reduced stress
  • Higher metabolism
  • More alert and active
  • Ability to utilize time for positive activities and so on

However, even if all the precautions are taken to live a healthy and well-balanced life, you cannot stay away from the risks of sudden illnesses or accidents. These may lead to hospitalization, different lab tests, surgery, emergency care, prescription drugs, etc. At this juncture, it is extremely critical that you choose the best affordable health care insurance plan.

The scope of health insurance is so vast that it can really be confusing for anyone to buy an appropriate heath care plan. In case you end up choosing the wrong plan, you will be spending more money on medical care than is actually required. Understanding the importance of buying the perfect health insurance plan plus people hardly finding the time to search for it, we decided to provide some useful tips.

Soon Open Enrollment 2017 will begin – from November 1st 2016. It is always better to conduct a thorough research on your requirements. However, in case you are hard pressed on time, there are five features that can guide you to buy the right health insurance coverage.

#1: Is the plan renewable for lifetime

All insurers under IRDA are mandated to insure you till you are 65 years old. After you have reached 65 years, you will be under the umbrella of Medicare. In case you are going to a health insurance marketplace, you would better find out if your private insurer is providing such lifetime limits. The rules state, every insured American must be provided a health plan with the option of lifetime renewability.

#2: No tests before 45 years

Mostly all insurers will ask you to visit for certain medical tests before issuing the policies. If you are under the age of 45 years, you are not required to undergo any medical tests legally, unless there are some serious health conditions. However, you are advised to undergo all the medical tests required and submit them to your insurer to ensure faster settlement of claims.

#3: Pre-existing conditions

No health insurance company is allowed to stop providing health insurance coverage due to pre-existing conditions. However, every company will provide health insurance coverage after 48 months from the date of issuing the plan. There are also some plans that provide health care coverage in case of pre-existing conditions after 36 months from the date of issuing the policy.

You need to check with your policy provider if they are giving adequate coverage for pre-existing conditions. ACA has made it mandatory for every company to provide health coverage for pre-existing conditions. You may even find some providers who will start coverage before the completion of 36 months.

#4: Outpatient department (OPD) and day-care facility included

Usually, the requirement before ACA was to remain hospitalized for a minimum of 24 hours to be able to claim health care bills. However, post-ACA, it has been made compulsory for the insurance providers to cover enrollees for day-care related health issues as well as OPD. Hence, make sure your health insurance plan has all the OPD and day-care facilities mentioned in its service provisions. Make sure you check all the facilities, as you may find certain conditions not existing in your plan.

#5: Sub-limits on policy

Ever since the ACA has been implemented, a big feature that you should always keep an eye on is- are there any sub-limits mentioned in your policy. In case of hospitalization, you may need a hospital room, doctor’s fees, different tests, surgery, physiotherapy, and a host of other hospitalization charges. Under sub-limits, your insurer may try to limit your coverage amount in each of these areas.

Make sure you look into the amount sanctioned under each sub-limit so that you are absolutely sure that you have not been deprived of coverage in certain areas.


The best way to buy a health insurance plan is by comparing at least 3 to 4 insurance providers. You will get a fair idea of what the providers are offering within the competitive rates they have to offer. If you have the time to do a detailed research, it is better you read more on ACA as well as Open Enrollment 2017.