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How to Compare Health Insurance Plans to Make the Best Health Insurance Choice

By , About.com Guide

Updated July 02, 2009

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Money Question #5: Is There a Cap on the Amount the Insurer Will Pay?

Missing this question has cost others their entire life savings, so pay close attention.

There are some newer health insurance plans that seem like a great deal because their premiums are so low, and their deductibles are manageable. What they don’t want you to figure out is that they limit the amount they will pay if you get sick or hurt.

Somewhere in the fine print, you’ll find a statement of annual cap, and/or a lifetime cap. The lower those caps, the lower your premium. A health insurance policy that costs you $10,000 over the course of the year in premiums, deductibles and co-pays, but limits your annual reimbursements to $20,000 is no bargain. You need to look for annual caps of $1 million or more, and lifetime caps of several million.

If you have trouble telling what those caps are, call the plan’s 800 number and ask. This is one aspect of a policy that health insurers use to block payments because so many consumers don’t know to ask about them. Some states are considering making caps that are too low illegal.

............................. These steps should help you choose the right insurance plan for you. You may need to adjust some of them according to your personal circumstances.

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