Tips for Choosing the Right Health Insurance Plan

To protect you from various expensive medical costs, it’s best to choose a great health insurance plan that works well with your current situation. Many people make the unfortunate mistake of buying into a plan that either doesn’t cover all of their expenses adequately or has an insanely high premium. Let’s take a look at how you can find the best health insurance plan for your situation.

Choosing the Perfect Plan

Be sure to fight the immediate urge to lower your premium payments for the month by choosing a plan that negates certain benefits like prescription drugs. Instead of doing this, you can simply lower your premium payment by either agreeing to a higher limit out-of-pocket or choosing a higher deductible. Keep in mind that by choosing this plan, you’ll receive virtually no initial benefits during the years that you are healthy. However, this is a great option to better protect you in the future from the high cost of medical bills.

How Do I Know That I’ve Found Great Insurance?

A great insurance plan, when found, will cover various types and kinds of medical care. This may include things like prescription costs, lab tests, preventative care, rehab programs, or doctor visits. This type of plan should also be able to cover all of your medical costs once you hit a certain amount for the year. Most people have limits on their insurance of between $5,000 and $10,000 that relate to payments made from co-insurance and deductibles. Once you go over this limit, the insurance company should cover all additional costs.

Some Different Options

Health Management Organizations (HMOs) are great health plans for their low-cost but often offer limited choices. With this type of plan, you are able to choose a primary care physician (PCP) who will help coordinate all of your medical visits. This way, if you need to see a specialist, you must first visit your primary doctor in order to get a referral. The one major downside with this type of plan is that besides being time-consuming, you must choose both doctors and hospitals that are within the HMO network. None of your costs will be covered under your plan if you choose to visit facilities outside of this network. This type of plan makes excellent sense financially because the co-pay is normally fairly low.

With a Preferred Provider Organization (PPO), certain doctors and hospitals work with insurance companies to offer discounted fees. This type of plan is nice because it does not require you to maintain a primary care physician, so seeing any medical specialist is quite easy, as there isn’t the need for a referral. Doctors and hospitals can be visited outside of the network under this plan, but costs will generally be higher.

With a Point of Service plan (POS), you are given features similar to a combination of both PPOs and HMOs. For instance, you must obtain a referral from your PCP in order to visit a specialist and to keep the costs low. When visiting facilities within the network, you must pay a small co-pay but aren’t responsible for meeting a deductible. If you intend on going outside of the network, your plan will act more like a PPO. In this case, you can refer yourself outside of the network but you will most likely have higher coinsurance and you must meet the deductible. For this reason, it is best to stay within the network for financial purposes.

Now What?

To find the past health insurance plan for you, you must find the best balance between need and budget. Always stick to a plan that you can afford and be sure that you understand certain benefits that you may be receiving and which benefits you may be losing. There are tons of plans out there to choose from and one of them is best for you.

Byline

This article was written by Karl Stockton for the team at Bailey & Partners.