How to Plan for Your Health Insurance Needs?
It’s no mean feat choosing a health insurance plan. In the US, the cost of healthcare is insanely high. Granted, the US offers the world’s best healthcare but the prohibitive costs are a major source of concern for the folks. With so many different types of healthcare plans available, it is often confusing and disconcerting to choose coverage. Whether you’re looking to pick a plan for yourself, or your family, it’s important to understand what’s covered by the plan, and what’s not.
For most of us, employment offers the easiest pathway to a health care plan. Many US employers offer tremendous healthcare plans, notably the global coffee company, Starbucks. If you happen to be employed, your employer is still legally bound to offer you a health care plan (under the provisions of the Affordable Care Act). There has been widespread political debate about the legality, burden and costs associated with employers being mandated to offer these services to their employees. However, there is no disputing the benefits enjoyed by people with good health coverage.
Get a Job and Get Health Insurance
Provided you have a ‘good employer’, you will not be required to use government-provided services in the form of exchanges and marketplaces. It is possible to use these alternatives to seek out a different plan than the one being offered by your employer. Unfortunately, the cost of plans in the marketplace is a lot more than employer-provided plans. For the record, employers are more likely to opt for a less affordable healthcare plan given that they pay a portion of the costs.
Currently, Obamacare has not been replaced, and the Affordable Care Act remains in place. It is possible to search for the lowest possible premiums in the federal marketplace by navigating to the official government website and entering your ZIP Code. Individuals can use private exchanges, or go direct to an insurer for healthcare coverage. There will not be any subsidies for these options, given that they are income-based discounts.
Once you have browsed the exchanges, you will come across all sorts of acronyms for different types of plans. These include POS plans, EPO plans, PPO plans, and HMO plans. These all stand for something different, and it’s important to know how to differentiate them. When selecting insurance coverage, it is imperative that you understand your deductible (out-of-pocket costs) as well as the coverage that is offered. The terms and conditions associated with each individual plan are comprehensive, and a little confusing at times. Since there are many health insurance plans available to you, it is best to choose one that is highly regarded by patients based on its performance, reliability, and cost.
What Plan is Best for You?
There are some important aspects to bear in mind when choosing a plan type. HMO plans require you to stay in network to get coverage, and referrals are required. PPO plans do not require in network medical services, but they are the least expensive option. No specialist referrals are required. EPO plans require you to stay in network, with the exception of emergencies. POS plans do not require patients to stay in network, although it is the least expensive option. Whenever you choose between different plans, it’s important to evaluate your needs and your family’s needs accordingly. It all depends on how you feel about referrals. Sometimes, you will want your primary care doctor to refer you for procedures and workups.
Making Dollars and Sense of the Healthcare Juggernaut
If you prefer to choose your own specialists, PPO plans and EPO plans are the better option. Remember that all insurance companies will offer you better rates in network than they will out of network. This is because they’ve worked out deals with doctors in their network. It is best to consult with your preferred medical specialist to determine whether they take your insurance or not. On that topic, it’s important to evaluate your out-of-pocket costs. Things like coinsurance, copayments and deductibles are necessary for many plans. If the costs of your plan are low, the out-of-pocket costs are going to be high. If you frequently visit doctors, you will likely prefer higher cost insurance plans with low out-of-pocket costs. By contrast, if you hardly frequent doctors’ offices, you will do better with a low monthly premium and high out-of-pocket costs.