Things To Know Before You Pick a Health Insurance Plan

health insurance

Choosing the right insurance plan can be tricky, even for the experts . Many health insurance companies offer a variety of insurance products, so it can sometimes be difficult to find the best plan. A good place to start is by asking yourself these questions: What insurance do I need? What insurance can I afford?

  • What insurance do I need?

When choosing insurance, it’s important to select a plan that includes the medications and treatment options you may need in the future. That way, if your health changes or you lose your job , you won’t be left without insurance coverage. You should also consider insurance for family members who may need care.

2.What insurance can I afford?

Health insurance premiums vary depending on your age, plan benefit levels and the insurance company you choose.   Here are some ideas that might help:

Shop around and compare prices. You could spend hours calling different insurance  companies, but that’s time you could spend watching your kids play soccer instead.

Work with insurance brokers who represent several insurance companies . They can find the plan that best meets your needs at a price you’re comfortable with. Many insurance companies offer insurance through community partners, like churches or associations. This may  help you get insurance coverage at a lower price.

Consider insurance plans with high deductibles. Your insurance premiums may be higher, but you’ll have to pay less out of pocket if you get sick or hurt.

When shopping around for insurance, ask the representative how much it will cost to visit your doctor of choice .What are  the co-insurance costs for specialist visits? What does the insurance company pay and how much do I pay? What are my out of pocket insurance costs if I am hospitalized or need surgery? Will insurance cover pre-existing health conditions ?  How many times can I visit a healthcare provider per year if insurance covers it? How frequently is insurance coverage limited? Does insurance cover mental health care ? If so, is it through a separate insurance plan or included in my insurance plan? What is the insurance company’s complaint and appeal process if I have a grievance with my insurance carrier? Can I add family members onto this insurance plan at any time?  How can I apply insurance benefits towards health promotion and disease prevention programs?

Learn more about insurance companies that offer insurance plans with flexibility for people who want to combine insurance with self-funded options. Understand the difference between “fully insured” and “self-funded insurance.”  Find out if you can enroll in insurance outside of open enrollment . Is there an open enrollment period? Is insurance available year round? What are the insurance company’s hours ? Does insurance cover pre-existing health conditions ? and so on and so forth.

Basically there are five types of US health insurance.

  • Health maintenance organizations (HMOs)

HMOs give you  access to certain doctors and hospitals. If you go to someone who isn’t part of your insurance company’s network , it may not pay for the services. HMO insurance plans generally cost less than insurance plans with other coverage options.

2.Exclusive provider organizations (EPOs)

With an EPO , your insurance company negotiates directly with healthcare providers for lower costs, which means insurance premiums are usually higher than HMOs . In return, you have fewer out-of-pocket expenses . EPOs generally require referrals from your primary care physician to see a specialist and limit the number of visits you can make to medical providers.

3.Point-of-service (POS) plans

POS insurance plans combine HMO and EPO insurance plan features. You typically have a primary care physician to manage your health, but you can see a specialist without a referral, and there’s no limit on the number of visits or how much insurance companies will pay for specialty medical care.

4.Preferred provider organizations (PPOs)

PPO insurance plans are similar to POS insurance plans. With a PPO insurance plan, you usually don’t need referrals for specialists. And if your primary care physician isn’t in the insurance company’s network , you can get care outside of the insurance company’s network without having to get pre-authorization from your insurance carrier. You typically pay less if you go to a doctor or hospital that’s part of the insurance network , but you can also see doctors and hospitals outside of your insurance company’s network without referrals.

5.Health insurance savings account (HASA)

A health insurance savings account (HASA) is an insurance plan that gives you money for medical expenses like doctor visits, hospital stays, prescriptions and more. You can use these funds tax-free to pay insurance premiums , co-pays, deductibles and other medical expenses. Unlike flexible spending accounts (FSAs), you don’t lose any money that’s left over at the end of the plan year . Plus, because insurance carriers are required to deposit your HASA contributions into a separate account, insurance carriers can’t use your funds for reasons other than paying insurance premiums , co-pays and deductibles.

spend a little bit of time to plan and choose the right health insurance plan  for you. and  make sure you  are on the insurance plan that fits your needs