Purchasing the best health insurance coverage for your family will give you greater peace of mind. Unfortunately, choosing the best insurance plan can be complicated. You must know how to choose an insurance plan to tackle this problem.
Knowing the trick of choosing an insurance plan is especially important if you or your family or dependent family have a particular health condition that requires ongoing treatment. In this case, you must choose the insurance plan with careful consideration.
5 Things to Consider When Choosing a Health Insurance Plan
Different health insurance companies offer different features and benefits in each of their insurance plans. To get the best protection from the health insurance plan, you need to consider these things.
1. How to Choose an Insurance Plan: Consider Deductible
When you are comparing health care insurance plans, you must check their deductible. It is the amount of medical cost you must pay on your own before the insurance covers your medical costs.
In general, choosing a health insurance plan with a lower deductible is a better thing to do. It is especially important if you plan to have a lot of medical treatment.
2. How to Choose an Insurance Plan: Consider Network
Network refers to hospitals, labs, and other medical providers/facilities that the insurance plan contracted with to provide your medical care. When you compare the network of different plans, you must look for your doctors and the size of the network.
It is essential to choose a network with your preferred doctors in it. Therefore, you can save on medical expenses because in-network doctors charge a more affordable rate.
In addition, you may want an insurance plan with a larger network so you have more choices of medical providers.
3. How to Choose an Insurance Plan: Consider Providers
Providers are your doctors. When choosing a health insurance plan, it is essential to choose one that has your preferred doctors in it.
4. How to Choose an Insurance Plan: Consider Prescriptions
Before you decide to buy a health insurance plan, you must understand how the plan covers your prescriptions. Different medical insurance plans have different coinsurance or copays for covered prescriptions.
Copay is the fee you must pay to receive a medical service or procedure. It is generally a flat fee. Meanwhile, coinsurance is the percentage of the medical costs that you must pay. For example, you must pay 20% of the medical costs, and the insurance company covers the rest.
5. How to Choose an Insurance Plan: Consider Value Added Benefits
Some health insurance plans offer additional things, such as discount programs, access to particular mobile apps, and 24/7 customer service. To get the most benefits, you must choose a plan that offers additional benefits suitable for your needs.
How to Choose an Insurance Plan: Health Plan Types
Insurance companies offer health insurance plans in different types. Each of these types has different policies. Therefore, you must understand them to decide which one to have.
1. Health Maintenance Organization (HMO)
These are some main points of HMO.
- HMO plan policyholders can only get medical treatments from health care providers in the network plan. However, those in an emergency may get medical treatments from out-of-network providers.
- This plan requires its policyholders to get a referral to have procedures and specialists.
- The benefits of being HMO policyholders are that you have a primary doctor who coordinates medical care for you and lower out-of-pocket costs.
- The drawback is that you have less freedom in choosing your medical providers.
2. Preferred Provider Organization (PPO)
Below are the main points of PPO.
- PPO policyholders do not need to stay in-network to get medical cost coverage. However, the in-network providers are more affordable.
- They can get medical care from specialists without having a referral.
- One of the benefits of purchasing this plan is that you have more freedom to choose medical providers. In addition, you don’t need a referral to have procedures.
- The drawback of this plan is it charges you higher out-of-pocket costs.
3. Exclusive Provider Organization (EPO)
These are some of the EPO policies and benefits.
- If you have the EPO plan, you will only be able to get medical treatment from medical facilities included in the network. However, you can get out-of-network treatments in an emergency.
- Typically, you don’t need a referral to get procedures and specialists.
- The advantage of having an EPO plan is that it generally does not require referral to get procedures. Moreover, you will spend lower out-of-pocket costs.
- Unfortunately, EPO gives you less freedom to choose medical facilities and providers.
4. Point of Service Plan (PSP)
The main points of PSP are as follows.
- PSP allows you to get healthcare treatments from out-of-network providers. However, they are more expensive than the in-work providers.
- If you purchase a PSP, you will need a referral for procedures and specialists.
- All in all, PSP allows you to have a primary doctor who coordinates your medical care and more choices of providers.
- However, it requires you to have a referral for getting specialists and procedures.
Lower Premiums or Higher Premiums?
Some people choose lower monthly premiums because they look more affordable. However, health insurance plans with lower premiums are not suitable for everyone. It is only good for people who are in good health or cannot afford the higher premium.
On the other hand, higher premiums will be more beneficial for those who need to see primary doctors or specialists frequently, need emergency care frequently, require expensive medications, etc. It is because an insurance plan with higher premiums has more coverage.
In addition, having health insurance plans with higher premiums means that you spend lower out-of-pocket costs. On the other hand, lower premiums offer fewer coverages. Therefore, you will spend higher out-of-pocket costs if you suddenly need to see doctors frequently.
Where to Buy the Insurance Plan?
In the US, you can purchase health insurance plans from a federal marketplace or private marketplace. You can also purchase it from the state’s online marketplace or the state’s exchange.
However, not every state has a state exchange. In addition, you must purchase the plan from the federal marketplace (state’s exchange) if you want to get discounts on the monthly premiums.
Health insurance is essential to have. Therefore, you must know how to choose an insurance health plan so you can give maximum protection to your family. When you choose a health insurance plan, you must ensure that the plan offers all the coverages you need at reasonable monthly premiums.
