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An Ultimate Guide to Choosing a Good Health Insurance Plan

Time is typically limited to select the best health insurance coverage for your family, but rushing and picking the wrong one can be costly. Here’s a start-to-finish guide to choosing the best plan for you and your family, whether through the federal marketplace or an employer.

Select Your Health Plan Marketplace

Most persons with health insurance get it through an employer. If you’re one of those persons, you won’t require to use the government insurance exchanges or marketplaces.

If your employer provides health insurance and you wish to search for an alternative plan in the exchanges, you can. But plans in the marketplace are likely to be costly. This is because many employers pay a portion of workers’ insurance premiums, and since the plans have lower total premiums, on average.

If your employer doesn’t offer health insurance, shop on your state’s public marketplace, if available, or the federal marketplace to find the lowest premiums. You can also buy health insurance through a private exchange or directly from an insurer. If you pick these options, you won’t be eligible for premium tax credits, which are income-based discounts on your monthly premiums.

Compare Kinds of Health Insurance Plans

You’ll encounter some alphabet soup while buying health insurance; the most common forms of health insurance policies are HMOs, PPOs, EPOs, or POS plans. The kind you select will help determine your out-of-pocket costs and which physicians you can see.

If you select an HMO or POS plan that needs referrals, you typically must see a primary care physician before scheduling a procedure or visiting a specialist. Due to this requirement, many people prefer other plans. Due to the restrictions, nevertheless, HMOs tend to be the most affordable type of health plan, overall.

POS and HMO plans may be better if you do not mind your primary doctor selecting specialists. One benefit is that there’s less work on your end because your doctor’s staff coordinates visits and handles medical records. If you do select a POS plan and go out of network, ensure you get the referral from your doctor ahead of time to reduce out-of-pocket costs. An EPO may help keep prices low as long as you find providers in the network; this is common in a larger metro area. A PPO might be better if you live in a remote area with limited access to physicians and care, as you may be forced to go out of the network.

Compare Health Insurance Networks

Costs are lower when you go to an in-network doctor since insurance carriers contract lower rates with in-network providers. When you go out of network, those physicians don’t have agreed-upon rates, and you’re typically on the hook for a higher portion of the cost.

If you have preferred doctors and need to keep seeing them, ensure they are in the provider directories for the plan you are considering. You can also directly ask your doctors if they take a specific plan.

If you don’t have a preferred doctor, search for a large network plan, so you have more choices. A more extensive network is crucial if you live in a rural community because you’ll be more likely to find a local doctor who takes your plan.

Compare Out-Of-Pocket Costs

Out-of-pocket costs are nearly as crucial as the network. Any plan’s summary of benefits should indicate how much you’ll have to pay out of pocket for services. The federal marketplace website provides snapshots of these costs for comparison, as do many state marketplaces.

As the shopper, your portion of costs comprises of the deductible, copayments, and coinsurance. The total you can spend out of pocket in a year is limited, and that out-of-pocket maximum is also listed in your health insurance information.

Compare Benefits

By now, you likely have your choices narrowed to just a few. To further winnow down, go back to that summary of benefits to see if any of the health insurance covers a wider scope of services. Some may have better coverage for things such as physical therapy, fertility treatments, or mental health care, while others might have better emergency coverage.

If you skip this quick but significant step, you could miss out on a plan that’s much better suited to you and your family.

Once you’re down to a couple of choices, it’s time to address any lingering questions. In some instances, only speaking with an individual will do, so it may be time to call the plans’ customer service lines.

Call for your Quote Today

Stop waiting around! The right insurance provider is out there and we’re going to make sure you’re covered for the foreseeable future. Accidents can happen any time whether it’s day, night, workdays, or holidays. Insurance is the best way to prepare for the unpredictable, and a great way to secure your peace of mind. Give us a call today or fill out the form for a quote – you’ll be glad you did!

Resources and References:

• Marketplace Health Insurance Plans and their Prices
• Health Insurance Networks