When it comes time to choose your health coverage plan, there are a lot of things that can weigh on your mind. There are so many mitigating factors that go into picking the insurance company and plan that is right for you, but there are simple steps to look over before choosing your best option.
Consider Your Health
When it comes to private medical insurance and what falls under your coverage, it is important to have a full understanding of your personal impact on your premiums and deductibles.
If you suffer from a pre-existing condition, health insurance can be impacted in certain cases. It’s important to find the health insurance coverage that is able to cover the event of seeing a specialist in order to help deal with a condition while registering copays and out-of-pocket costs that are not too steep on your bottom line.
There are certain factors that can actually raise your price of health insurance, like whether or not you are a smoker or disease prevalence.
Understand what each plan means.
You’ve probably seen initials like HMO or PPO when you enter your employer’s open enrollment period but aren’t sure what exactly that means for coverage. Health Maintenance Organization, or HMO, usually means lower out-of-pocket costs and a primary health care provider who will coordinate the care for you, but comes with fewer options when choosing your doctors.
Preferred Provider Organization, or PPO, means more provider options and no required referrals, but more money out of your wallet. Exclusive Provider Organization, or EPO, means less of a cost to you and no need for referrals, but it also limits your scope of providers under your health insurance policy.
Point of Service plan, or POS, allows for more health care provider options and a primary care physician that coordinates care for you with referrals needed to see specialists.
Who is your coverage for?
When choosing your health insurance coverage, it is important to keep in mind who the plan is for. Individual health insurance plans will account for your wellbeing, but additional costs will be implemented through corporate plans to cover other members of your family.
If you are planning to have children, it is a good idea to consider a family health insurance plan that assures others in your family are insured for primary and basic care. If you have senior citizens under your care plan, you can consider options that will work secondary to Medicare or Medicaid as supplemental insurance to cover additional expenses.
If operating under a corporate-sponsored health care plan, you should look at all of the options at your disposal during the open enrollment period, including dental and vision. Beyond those additional and separate coverages from your health insurance policy, there are add-ons that you can pay to provide more of a safety net. Supplemental health insurance plans can provide additional coverage in the event of critical illness or need for hospitalization.
You can also look into short-term insurance to bridge any gaps in coverage. This is recommended if you are planning on changing jobs, and need to be protected for a brief period of time until your new policies kick in.
Actual health care expenses vary, depending on your deductible, coinsurance, and out-of-pocket maximums. A deductible is how much you will have to spend on covered services before your insurance company pays anything. This excludes free preventive services. Coinsurance, or copay, is the amount you spend each time you get a medical service to reach your deductible. An out-of-pocket maximum is the most you have to spend for covered services in a year.
Most health insurance companies allow you to view plans side by side to estimate your total costs and preview plans, including monthly premiums, to decide what is best for you and your loved ones.