5 Things to Know Before You Choose Your Health Insurance Plan

May 16, 2019 by  
Filed under The Fitness Bug

Choosing your own health insurance plan can feel downright overwhelming and stressful. There are so many things to budget for and so many confusing terms, where do you even begin? You know you need the right coverage to make sure you have access to quality, affordable care, but you’re unsure how to get started.

 

Before you choose your health insurance plan, whether you’re going with an employer-sponsored plan or something from the federal marketplace, make sure you read through these things. There are a lot of misconceptions about health insurance that prevent you from getting the care you need. Don’t let that happen to you.

 

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1. Understanding The Plan Types

First, you need to know how the different types of health insurance plans work and are categorized. Some plans allow a lot of flexibility, and you can see different doctors and use different facilities at a similar price. On the other hand, some plans limit which providers you can see, but they might charge you less for coverage. Here are some of the most well-known plans:

 

  • Health Maintenance Organization (HMO) – Limits coverage to care from doctors in-network without covering out-of-network care except for emergencies.

  • Preferred Provider Organization (PPO) – Pay less if you use in-network providers, but you’re able to use outside providers for an additional cost.

  • Point-of-Service (POS) – Pay less to use in-network providers, but you can see an out-of-network provider with a referral.

  • Exclusive Provider Organization (EPO) – Care is managed by a primary care physician and you need a referral for outside coverage.

2. Part-time or Unemployed Plans

There’s a lot of confusion about how to gain access to health insurance coverage. If you’re not employed full-time or if you decide you don’t want to choose a plan through your employer, you still have options. By searching an online marketplace, you can review plans from recognized national and regional insurance companies to find the right one for you no matter your employment status.

3. Metal categories

Most healthcare plans are categorized not only by plan type but also by “metal” categories. These categories are actually a way to show you just how much you’ll expect to pay for your coverage. However, these categories in no way indicate the level of care you’ll receive or even your providers.

 

Plans range from bronze coverage to platinum coverage, with bronze being the most affordable and platinum being the most expensive. The more you pay in monthly premiums, the less you can expect to pay out-of-pocket.

4. Indemnity vs Managed Care

Another way to categorize insurance is to consider whether the plan is an indemnity health plan or a managed care system. An indemnity plan is known as a fee-for-service plan, and this is any plan in which you pay a percentage of your medical costs while the insurance provider pays the remaining costs. You have more flexibility with your doctor and provider coverage with an indemnity plan.

 

On the other hand, a managed care system requires you to choose a provider who’s under contract with your provider. Both HMOs and PPOs are examples of managed care. For this, your employer usually pays a fixed monthly fee for services, and you’ll need to stay in-network for the best cost of service.

 

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5. Supplemental Insurance

Finally, recognize that most traditional health insurance plans don’t include coverage for “supplemental” things like dental and vision insurance. These are considered extras that usually need to be purchased as an additional plan. Luckily, supplemental plans are very affordable. For instance, dental insurance costs anywhere between $14 and $30 a month, so it’s not a huge expense as long as you stay up-to-date with preventative care.

6. Choosing Your Health Insurance plan

It’s time to choose the best health insurance for you at a price you can afford. Don’t fall victim to any of the common health insurance myths and listen to the tips above. It doesn’t have to be unaffordable to have the care you need when you need it.

 

While it’s true there are a lot of complex parts of healthcare to figure out, it’s not impossible to discover what you need to choose the best plan. You’re now ready to make a smart decision to protect your health for the future.

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