When it is time to choose a health insurance plan, there is usually not much time involved. This can lead to you rushing. You would end up picking something that is not at all that great for you. Avoid this by following the advice presented in the following paragraphs.
Choose The Correct Health Plan Marketplace
In most cases, people get their health insurance through the employer. In this case, you do not need to utilize marketplaces or government insurance exchanges. Basically, the marketplace is the company.
When the employer gives you health insurance and you want to look for alternatives, it is something that has to be respected. However, in this case, costs will be higher. Most employers will pay for a part of the premium. This is because such plans have, on average, lower premiums.
When the job does not offer health insurance, you need to shop. Do this on the public marketplace of the state or look at federal marketplaces. You can start with a search on HealthCare.gov. Just enter the ZIP code and you can see what is available. Alternatively, US health insurance is available directly from insurers and through private exchanges. When such options are chosen, premium tax credits are not available since these are based on the monthly premiums.
Compare Health Insurance Plans
When you analyze the different health insurance policies, you quickly notice several acronyms. It can be difficult to compare deals when you do not know what these mean.
A great thing to do is to compare plans. When you do this, look at the listed benefits. In an online marketplace, you normally see links to such summaries that allow you to quickly skim through what is available. Also, make sure to check the provider directory. This lists clinics and doctors participating in the network. When using the employer, analyze workplace benefits. You can learn about these when you discuss them with the company administrator.
The common health insurance plans are:
- HMO – Health Maintenance Organization.
- EPO – Exclusive Provider Organization.
- PPO – Preferred Provider Organization.
- POS – Point Of Service Plan.
As you compare the different health insurance plans, think about the medical needs of your family. See what type of treatment and how much was received. It is not possible to predict all future expenses but when you know the trends, your decision will be much more informed.
When you choose POS or HMO plans, they need referrals. Typically, this means you have to go to a specific primary care physician before specialists are visited or procedures are scheduled. As a result, most people just prefer the other plans. Because of the restrictions, HMOs are quite cheap.
HMO and POS plans are better when you do not mind the fact that the primary doctor will be choosing what specialists to go to. You do not have to do much work and the staff of the doctor handles your medical records and coordinates medical visits. When opting for the POS plan, if you decide to go to a doctor that is not in the network, you have to pay for medical expenses.
If you want to be allowed to choose the specialists you visit, the PPO or the EPO has to be considered. EPOs keep costs low but only when you are inside the network. Such a thing is highly beneficial when living in larger metro areas. With PPOs, you have an advantage if you live in rural or remote areas that have limited access to care and doctors. This means there is a higher possibility you will need to go to specialists outside the network.
High-Deductible Health Plans (HDHP)
Sometimes you will see that you get or are on an HDHP. This can be a health insurance policy of any type already highlighted. However, there are some extra specific rules that have to be respected. They have lower premiums and you will have to pay more out of your pockets. But, you need to be careful of the rules.
Compare The Available Health Plan Networks
Insurance companies will contract lower rates when working with in-network providers. This is why costs are always lower as you visit such doctors. When you decide to go outside of the network, the doctors you visit do not charge the lower agreed rates. This is why you pay more.
When you do have some preferred doctors and you want to keep visiting them, see if they are included in the directories for the health insurance plan you now consider. Alternatively, you can ask doctors to see if there is a health plan that they take.
When the preferred doctor does not exist, try to find plans with very large networks. This gives you access to more choices. It is particularly beneficial when you live in a rural area because there is a much higher possibility you will locate doctors taking your plan. If possible, eliminate all the plans that do not have in-network doctors close to where you live and do the same for those that have just a few provider options.
Analyze Out-Of-Pocket Expenses
These are just as impo0rtnat as the healthcare network you sign up for. The summary of the benefits has to clearly state the money you will need to pay for the services. You will need to be aware of the main terms used in health insurance though, like deductibles, coinsurance, and copayments. How much you spend per year will be limited and the maximum is surely listed in the plan information section. Generally, when your premium is lower, you pay more during actual doctor visits.
As you analyze these expenses, you have to narrow down your choices. The plan that does pay for a large portion of the medical costs can be better for you when:
- You frequently visit a specific specialist or primary doctor.
- Emergency care is often required.
- You regularly take brand-name or expensive medications.
- A surgery is coming up.
- You are pregnant, want to become pregnant, or have young children.
- You suffer from a chronic condition like cancer or diabetes.
The plan that involves high out-of-pocket payments and monthly premiums that are lower are quite a good choice when:
- You cannot pay for the high monthly premiums.
- You rarely go to a doctor and your health is generally good.
Compare The Health Insurance Benefits
After you do everything already mentioned, there is a very good possibility you end up with a short list of US health insurance policies you can consider. You will not have to narrow things down much now. Just go back to the summary of the benefits so you can see exactly what services are covered. There are plans that have much better coverage for specific things like fertility treatments, mental health care, or physical therapy. Other plans give you access to much better coverage for emergency situations.
Basically, you want to compare all the extra services included in health insurance plans so that you can avoid the unwanted situation in which you miss out on that plan that is great for your entire family.
After you end up with just a few options to choose from, you have to do the last comparison. Sometimes, you just have to talk to a representative of the insurance company to get all the answers you need. In others, you have to contact customer support. No matter what option you choose, before you contact the insurer, write down all the questions you have. This allows you to ask everything you want to know.
Some questions that you could always ask are:
- Will I be covered by this health insurance plan when I take medication X?
- What drugs are covered for my condition?
- Are there specific maternity services that will be covered?
- What documents are needed to sign up?
- What will happen in the unwanted event that I get sick when abroad?
Discontinue the old health insurance plan after you get the new one and you are good to go. Preferably, do this before you sign the contract since you would save some money.
Final Thoughts
Health insurance is something that we all need because we never know what the future holds. Because of this, you should always take the time you need to find the very best policy for you and your entire family. Never underestimate how much you will need the help offered by health insurance if you get ill.
Fortunately, there are countless health insurance policies you can choose from right now. All you have to do is to carefully compare them and get the one that is best suited for your personal needs.
The big problem is most people hurry. They just choose the very first health insurance policy they locate on the internet. Never make this mistake. Be especially careful with deals that seem to be too good to be true. When an insurer promises the world, you most likely end up paying too much on premiums or there are many fine prints that are not presented.
Make sure to read every single line of the contract you sign. Dishonest insurers know a lot about how to hide shady practices in their contracts. When you have doubts, ask someone that can help you.
By Andrew Simmons
Bio – Andrew Simmons is an experienced digital marketing consultant and a passionate blogger. He has a vast knowledge of search media and online advertising to promote online branding and reputation. He loves to share his industry knowledge and experience with readers.