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I have been a health insurance broker for over a decade, and every day I hear more and more "horror" stories of health insurance companies not paying claims, refusing to cover specific conditions, and physicians not being compensated for medical services that are listed on the Internet. Regrettably, insurance firms are motivated by profits rather than by the needs of their customers (albeit they need people to make profits). If an insurance company can find a legal justification to refuse to pay a claim, they will almost certainly do so, and you, the consumer, will suffer as a result. What most people don't realise is that an insurance policy has relatively few "loopholes" that provide the insurance company an unfair advantage over the consumer. In truth, insurance firms go to considerable lengths to explain the restrictions of their coverage by allowing policyholders a 10-day period to study their policy (a 10-day free look period). During their 10-day free look, most people store their insurance cards in their wallets and their policies in a drawer or filing cabinet, and it isn't until they receive a "denial" letter from the insurance company that they pull their policy out to study it thoroughly.

When it comes to explaining the plan's coverage and benefits, the majority of people who buy their own health insurance rely mainly on the insurance agent selling the policy. As a result, many people who buy their own health insurance plan can tell you very little about it.

Purchasing a health insurance policy on one's own can be a daunting task for many people. Buying health insurance isn't like buying a car; the consumer knows the engine and transmission are standard, but power windows are optional. A health insurance plan is much more vague, and it's sometimes difficult for consumers to figure out what types of coverage are included and which are optional. This, in my opinion, is the main reason why most policyholders are unaware that they are not covered for a certain medical procedure until they receive a huge bill from the hospital indicating that "benefits were refused."

Sure, we all chastise insurance companies, but we all recognise that they are a "necessary evil." Even though buying health insurance can be a difficult, intimidating, and time-consuming process, there are some things you can do as a consumer to guarantee that you are getting the type of coverage you need at a reasonable price.

Working with small business owners and the self-employed sector, I've discovered that distinguishing between the type of health insurance coverage that people "desire" and the advantages that they truly "need" is exceedingly challenging. I've recently read a number of comments on various blogs favouring health plans with 100 percent coverage (no deductible and no coinsurance), and while I agree that these plans have a lot of "curb appeal," I can tell you from personal experience that they are not for everyone. Do 100 percent health insurance provide better peace of mind to policyholders? Probably. Is a 100 percent health insurance plan, however, something that most people require? Almost certainly not! When purchasing health insurance, you must strike a balance between four crucial criteria, according to my professional opinion: wants, needs, risk, and price. You must examine all of these variables before spending your money, just as you would if you were choosing choices for a new car. Do you really need a 100 percent coverage with a $5 co-payment for prescription pharmaceuticals if it costs you $300 more per month if you are healthy, take no prescriptions, and rarely go to the doctor?