Health insurance options are there to enable you to pick the choice that is suitable for your health needs. Also, you have to consider your family and the type of health challenges they face to pick properly. You should also think of how you will pay for the insurance option you choose. Because of how important health is and the desire to make your search easy, I have done the research so pay attention to all you read in this article. Here’s a guide to choosing the best health insurance options for you and your family.
A Guide to Choosing A Good Health Insurance Plan
Step 1: Choose your health plan marketplace
Many people get their health insurance from their employers. If you have one from your employer then, you don’t have to go to the government insurance exchanges or marketplace. Your company is your insurance exchange or market place.
But you may choose to look for alternatives to what your company has put in place. But note that it will cost more than what you are paying through your employer’s insurance. The reason is that your employer pays part of the insurance premium and also the overall average coverage premium payable compared to the market place is lower.
However, if your company does not offer a health insurance plan, to get the lowest premiums, you can search from your state or federal market place. To enroll, go to Healthcare.gov and type in your ZIP and then you will be redirected to your state exchange if available. If not you can use the federal exchange.
Besides, you may buy health insurance from a private exchange or from an insurer directly. But, if you select these options, you will not qualify for premium tax credits. Because they depend on your income and the discounts on your monthly premiums.
Step 2: Compare types of health insurance plans
There are many types of health insurance options or insurance coverage. Also, when you are searching for a plan you will come across words like HMO, PPO, EPO, and POS. Note that the plan you select determines the Doctors you will see. And the out of pocket expenses you will make in the future.
You can compare the plans by looking at the summary of benefits for each plan, and the cost. You will also see a link that contains a list of doctors and clinics in each plan’s network. If you are using your employer’s exchange, ask your benefits administrator for the breakdown.
Summary of Each Plan
Now that you are trying to make a choice of the health insurance options that is suitable for you and your family, go through this quick summary of each plan.
- HMO: Health Maintenance Organization: You must be in a network to get coverage except it is an emergency. And you must provide a referral to see a specialist or book a procedure. Also, you will spend less out of pocket costs and have a primary doctor that takes care of you. But you have little freedom to select health care providers.
- PPO: Preferred Provider Organization: You don’t have to be in a network to get coverage and the cost is lower. Also, you don’t need a referral to see a specialist and book a procedure. And you have more choices to pick a provider. But you spend higher out of pocket costs.
- EPO: Exclusive Provider Organization: You must be in a network to get coverage except it is an emergency. You don’t need a referral to see a specialist or book a procedure. You spend less on out of pocket costs, have less power to pick providers.
- POS: Point of Service Plan: You don’t have to be in a network to get coverage. But if you are in coverage, you pay less for health care. Also, you need a referral to see a specialist and book a procedure. And you have more options to pick a provider, plus a primary doctor that treats you.
Think about your family’s need for health care, and use past expenses to make an estimate of future costs. For example, if you pick the HMO or POS plan then each time you need to see your main doctor, you must get a referral or to book a procedure. That is why more people choose other plans.
But HMOs are the cheapest type of health insurance plan. POS and HMO plans could be the best choice if you would love your primary doctor to pick specialists for you. But if you want to pick a specialist personally, then you should choose PPO or EPO.
Step 3: Compare health plan networks
Comparing the health plan networks to help you pick the best health insurance options is important. Also, it is usually better and cheaper when you use an in-network doctor because insurance companies have discounts from in-network doctors. You will pay more when you go out of the network.
But if you have doctors you prefer and like to continue to see them then, confirm that they are in the provider directories for the plan you want to pick. You may ask your doctor if they are part of the directory. But if you have no special preference for a doctor, then pick a plan with a large network to give you more choices especially if you are living in a rural area.
Also in step 4: Compare out-of-pocket costs
When you are considering the best health insurance option for you and your family, compare out of pocket costs. Compare this cost because they are as vital as the network. Find out the exact amount you have to pay as out of pocket for any plan you pick. Use the federal and state websites to give you a summary of what you have to pay.
Also, learn a few insurance vocabularies so go through the meaning of “deductible, copayments, and coinsurance” Note that the lower your premium the higher you have to pay as out of pocket costs.
Your aim at this point is to pick a plan based on out of pocket costs. So you will be better with a plan that you pay a higher medical cost with a higher monthly premium.
Step 5: Compare benefits
Before you make a final choice for a plan go through the benefits of the health insurance options again and compare the summary of the entire plan. So to discover if any plan has a wider coverage, do another comparison. Some may cover things like physical therapy, fertility treatments or mental health care, while others may have coverage for a better emergency.
After narrowing your options to a few, then ask the customers services of those organizations questions like if a certain medication you take is covered, drugs that are covered if you have a medical condition, maternity service, if you travel abroad and fall sick and how to sign up plus the documents they need. Finally, cancel your old plan if you had one before you start a new plan.
This post gave you a guide for choosing a good health insurance options for you and your family. To begin the process, choose your health plan marketplace, then compare the types of health insurance plans, and the out-of-pocket costs and finally weigh the benefits and pick the one that is better.