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4 tips for choosing the right health care plan

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MNsure call center
Loretha Cager talks with an applicant at MNSure's call center in St. Paul in March. Minnesotans in the market for health insurance can start shopping Saturday on MNsure, the state's healthcare exchange.
Ann Heisenfelt/AP

In the world of health insurance, options are usually a good thing. But when it comes to actually choosing a plan, options can be overwhelming — especially when there's a lot of money at stake.

Minnesotans in the market for health insurance can start shopping Saturday on MNsure, the state's healthcare exchange

To help sort through the choices, MPR's Steven John talked to Julie Rovner, a senior correspondent with Kaiser Health News. She offered some basic guidelines for choosing the right plan.

4 tips for choosing the right healthcare plan

1. Know yourself. Thinking about your personal health and outlook is the most important thing when choosing among plans, Rovner said. If you can predict high medical expenses next year — if you plan to have a baby, for example, or to have that surgery you've been putting off — you are likely better off going with a more robust, higher-premium plan.

2. Don't be fooled by premiums. There tends to be a trade-off between the cost of the deductible — how much you have to pay out of pocket before your insurance kicks in — and the cost of the premium, which is what you pay per month for the insurance.  

Plans with higher deductibles tend to have lower premiums, and vice versa. Last year, a lot of people shopped based on premiums alone. The problem is, if you know you'll have an expensive prescription to buy — or other predictable health expenses — it may actually be cheaper to go with a higher premium plan.

3. Map your provider network. Each plan comes with an out-of-pocket maximum, which is the maximum amount you pay before the insurance takes over all your expenses. But that maximum only applies if you go to doctors or hospitals within your network. So, if you have a plan with a very narrow network, and you go to a doctor outside that network, you may be faced with a very large bill. 

4. Your subsidy may have changed since last year.  Subsidies are pegged to the second-lowest-cost silver plan in your area. In many places, that plan has changed, which means that the value of your subsidy will change. And that means it's very important to shop around, even if your plan is still offered this year.