Health Insurance plan can be a difficult decision to make. With the vide variety of options available and the number of options and variables involved, choosing a single plan often feels impossible. This article aims to give a concise summary of the variables involved and how they matter.
Know the types of health insurance plans
An insurer’s network are the health care providers they have partnered with, to provide health care at a lower cost. There are a number of types of insurance plans available for you to buy. The basic types are HMOs, PPOs, EPOs, and POS plans.
- HMOs or Health Maintenance Organization: These offer lower costs but require you to stay within the network of your insurance provider.
- PPOs or Preferred Provider Organization: These do not require you to stay within the network but the treatments obtained within the network are less expensive. These are good if you want more medical facilities as options and are willing to pay more than HMOs.
- EPOs or Exclusive Provider Organisation: These are similar to HMOs, they require you to stay in network and offer lower costs, but they do not require referrals from an assigned doctor.
- POS or Point of Service Plans: In these plans, care received in-network is less expensive and it requires a referral to go outside the network.
To know which plan would suite you the best, you need to put your and your family’s needs under careful observation. Look into your history and see which type of solution would be most economically friendly as well as ideal for your family’s health.
A plan which requires referrals (such as HMO or POS) requires you to see a primary physician before you can schedule an appointment with a specialist. These plans are better if you’re willing to let your primary doctor choosing your specialists. If this sounds like something you would like to avoid, then PPO or EPO plans might be better options.
Compare the networks
An insurer’s network comprises of doctors and other health care providers. Staying within the network of your provider is much cheaper than going outside of it. If you have doctors you prefer or need a certain kind of treatment, it is always important that you have the appropriate physicians or facilities within the network. Eliminating any plans which do not have decent local network is also an advisable idea.
Compare costs and benefits
Each plan has a different cost associated with them. A plan with higher premiums usually pays more of your medical bills and can be a good idea if you need to receive medical treatment frequently. On the opposite side, if you rarely see a doctor and are in good health, then a lower monthly premium might suite you better. Benefits are also important. Some plans offer better coverage of certain things such as physical therapy or mental health care but others may have better emergency coverage.
It can be a daunting task to choose a plan, but by eliminating plans using systematic evaluation you can reduce the number of options greatly and make the task easier for yourself.
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