When choosing a health insurance plan, it is important to consider your healthcare needs, budget, and preferences. Health insurance plans vary in terms of coverage, benefits, premiums, deductibles, networks, subsidies, and enrollment periods.
To choose the right health insurance plan, start by assessing your healthcare needs. What prescription medications do you need covered? How many doctor visits, hospitalizations, or surgeries do you usually have in a calendar year? Then, consider your budget - how much you can afford to pay for? This is not only in health insurance premiums, but also in deductibles and copays.
Next, evaluate the coverage and benefits of different health insurance plans; such as preventive care, maternity care, mental health services, and prescription drug coverage. Also, check the network of healthcare providers. It's important to verify that you can see your current Doctor, and that you have a wide range of providers to choose from.
Choosing the right health insurance plan can be a daunting task, especially if you're not familiar with the terminology and various types of plans available. To make the process easier, we've put together the ultimate guide to help you choose the right health insurance plan for your needs.
Here's a list of definitions for your search:
Deductible - The amount of money you must pay out of pocket before your insurance coverage provides coinsurance (+50% or above on covered services).
Co-pay - A fixed amount you pay for each medical service or prescription drug covered under your plan.
Premium - The amount you pay each month for your health insurance coverage.
Out-of-pocket maximum - The maximum amount you will have to pay for covered medical expenses in a given year.
HMO - Health Maintenance Organization. This is a type of health insurance plan that typically requires you to choose a primary care physician to coordinate all of your healthcare needs. Typically these are local.
PPO - Preferred Provider Organization. This is a type of health insurance plan that allows you to choose your healthcare providers from a network of preferred providers. Typically these are state-wide or nationwide.
EPO - Exclusive Provider Organization. This is a type of health insurance plan that requires you to use providers within a specific network, but does not require you to choose a primary care physician. Typically these are state-bound.
When it comes to health insurance, there are several types of plans available. These include HMOs, PPOs, EPOs, and POS plans. Each plan has its own benefits and drawbacks, so it's important to understand what each plan offers before making a decision.
For many, the top priority is the network of providers. HMOs typically have a more limited, local network, while PPOs and POS plans offer more flexibility in choosing providers. EPOs are similar to PPOs in that they offer a broader network of providers, but they typically do not cover out-of-network care and are often limited to your state.
There is almost always a way to get all of your needs checked while still remaining in budget - on the public market, low-income applicants can get as low as $0 monthly premium plans if they qualify. On the private market, good health can earn you superior benefits and a relatively low rate, depending on your medical risk to the insurer
Selecting the right health insurance plan is almost always situational, which is why as a health insurance agent, my job is to assess your situation and make the process as seamless as possible. That's why the ultimate resource in shopping for health insurance is an agent that you can trust. Contact me today and we'll make sure that you choose the right health insurance plan!