Having to shop for health insurance is often an overwhelming process. However, having health insurance is something that is important. When faced with questions such as, “what’s better – a low premium or low deductible?” having some helpful tips and insight can be invaluable.
If you currently receive health insurance coverage through your employer, you may not have an option when it comes to the type of coverage you get. There are some companies that just offer one plan. While this is true, there are others that offer you several plans to choose from.
For those who don’t get coverage through their job, there are even more options. Unfortunately, all the acronyms and company jargon can be confusing and make you unsure of what to do or what plan to choose.
The good news is, there’s help. When investigating and learning about health insurance and trying to select the right plan for you, keep the information here in mind.
Get to Know the Different Types of Health Insurance Plans
Health insurance plans are categorized based on how they work. Each of the plans below has unique features to understand.
EPOs – Exclusive Provider Organization
EPOs provide you with a network of providers to pick from. You can only use the providers “in-network” to be covered. The only exception is in emergencies.
There’s no coverage for out-of-network providers. You may also have to pay coinsurance, copayments and deductibles with the EPO plan.
HMOs – Health Maintenance Organization
An HMO typically has a list of providers that will accept your insurance and require you to choose a primary care provider. This provider is the “point man” regarding all your healthcare needs.
The limited provider options and the need to have a primary care provider are all designed to help keep premiums and costs lower. If you have to see a specialist with an HMO, you have to see your primary care doctor to get a referral.
PPOs – Preferred Provider Organization
A PPO also has a list of providers the insurance company considers an in-network provider. These plans have providers that have pre-negotiated rates, which keeps costs down.
Unlike an HMO, the PPO does not require you to visit your primary care provider to get a referral to a specialist – you can just go.
Where to Find the Health Insurance Coverage You Need?
Understanding the types of health insurance coverage available is just a first step. Now you need to look into what options you have.
There are several places you can find these plans.
At Work
If you qualify for health insurance through your job, you company may pat for part or all of your premiums. If you don’t qualify for health insurance through your job, you can shop for coverage during open enrollment.
Insurance Agents
Another option is to use an insurance agent that represents a single health insurance company or an insurance broker, who provides options from several service providers. A broker is going to provide more options, but if there’s a specific company you want to be insured by, then going to an agent that represents that company is fine.
Insurance Aggregator
Along with shopping on the health insurance exchange during open enrolment, you can use additional professionals and websites to help. There are some websites that have collected information about health insurance plans and created helpful comparison guides to make the process of finding the right policy easier.
Monetary Considerations
For most people, the cost of the health insurance plan is a crucial factor when they are making a decision. Some of the financial considerations you have to look into include your premium (the monthly payments made for the coverage); the deductible (how much you have to pay out of pocket before coverage kicks in); coinsurance and copays (this is how insurance companies spread out the costs of service to ensure you get what you need); and the maximum out of pocket costs (these are how much you will pay for health coverage every year).
Selecting the Right Health Insurance Plan for You
In the end, selecting the right health insurance plan is somewhat of a puzzle and you have to consider things like your budget, the specific services that you need, and how you want the plan to work. You also have to consider the insurance options provided.
Take some time to figure out what’s most important to you and what works with your budget. This will help you find the best plan.