How to Find the Best Health Insurance Plan for Your Needs
The health insurance world is a tricky one to navigate. However, with the right tips, you will be able to choose the best insurance coverage for your needs. Here are some tips that will help you to find the best health insurance plan:
Find Your Marketplace
If you are employed, you will get health insurance through your employer. This means that you do not have to go through marketplaces and government insurance exchanges. If you are employed but still want to find an alternative plan, you can do it. However, you need to know that plans in the marketplace will cost more than your employer’s insurance.
If your employer does not provide insurance, you should visit the federal marketplace or your state’s ACA marketplace. When you shop from the ACA marketplace, every plan will have essential health benefits, which is good. You can also buy health insurance directly from the insurer or through a private exchange.
Compare Different Plans
When shopping for plans, you will come across different alphabets that you might not understand: PPOs, POS, HMOs, and EPOs. The plan that you opt for will determine the doctors that you can see as well as your out-of-pocket costs. When comparing different plans, you need to look at the summary of benefits.
HMO: Stands for Health Maintenance Organization and you have to remain within the network to keep your out-of-pocket costs low. You have to get a referral from your primary care physician to see specialists.
PPO: Preferred Provider Organization does not require you to remain within the network but in-network care is cheaper.
EPO: Exclusive Provider Organization is a plan that requires you to stay in-network unless it is an emergency and it does not allow referrals.
POS: A Point of Service plan requires you to remain in-network for cheaper costs but you can get referrals to go out-of-network.
When comparing these plans, you need to look at your medical needs carefully. Although it is impossible to predict your future medical expenses, you can make an informed decision once you know the trends. If you opt for a plan that allows for referrals, you will have to see your primary doctor to get permission to see specialists.
Compare Plan Networks
Costs are usually lower for in-network care because your insurance company has arranged contracted rates with providers within the network. On the other hand, out-of-network care is costly because no contracted rates are arranged. If you already have a doctor that you would like to keep going to, you should ensure that he is in the provider network of the plan you are considering.
If you do not have a preferred doctor, you should go with a plan that allows you to have more choices and eliminate any plan that does not have local in-network doctors.
Compare out-of-pocket Costs
The summary of benefits of any plan should state how you are to pay for out-of-pocket costs. Your costs will include coinsurance, copayments, and deductibles. You should choose a plan with high premiums and low out-of-pocket costs if:
- You need frequent emergency care
- You have an upcoming surgery
- You see a doctor frequently
- You have recently been diagnosed with a chronic illness
- You take expensive medicine regularly
- You are expecting a child
On the other hand, you need a plan with lower premiums and high out-of-pocket costs if:
- You are young and healthy
- You cannot afford high premiums
Choosing the best plan for your needs is not easy but the above steps will help you. Have you turned 65 recently? You should look into Medicare costs because you will be enrolled automatically if you receive social security benefits.