22 Lessons Learned: Life

How to Choose a Health Insurance Policy

Health insurance has become necessary for just about everyone, given the high cost of medical treatments today. However, policies can differ radically in terms of cost, coverage and features, it’s crucial that you go through your options carefully before making a choice. You also have lots of insurance companies to choose from, which may make choosing a bit more difficult. Of course, if you do your homework, the task will be much easier.

Type of Policy

Health insurance policies come in several basic types, and the following are the most well-known:

Health Maintenance Organizations (HMOs)

If you have an HMO policy, you may only use healthcare providers in the policy’s network. And you can only see a specialist if you have a referral from your primary care physician.

Preferred Provider Organizations (PPOs)

While PPO health policies have networks too, but you will not be confined to their in-network health care providers, and there’s no need for you to get a referral if you want to see a specialist.

Exclusive Provider Organizations (EPOs)

EPOs are like half HMO, half PPO. You have to stick to their network, but you are free to see specialists with a referral.

Point of Service (POS)

PPO plans, which are probably the least common of all the other types, are the opposite of EPO plans. A referral is required for an appointment with a specialist, but you can see any doctor outside the network.

High Deductible or Low Deductible?

As a general rule, higher-deductible plans will have lower monthly premiums. Your deductible is the amount of healthcare expenses that you have to cover out-of-pocket before coverage takes over. If your yearly medical expenses are low to none, a high-deductible plan can be a bargain. Otherwise, it may be wiser to go for a low-deductible policy.

How to Compare Coverage

The two most crucial factors that dictate how good a policy will be for you, are its network and the policies for coverage. Even with a plan that provides out-of-network options, you’ll probably want to use in-network providers because it will let you save money. And a plan’s coverage rules, including your copay rate, can also make a huge difference in terms of a policy being actually good for you or not.

Choosing the Best

Are you having a hard time choosing between to policies that both seem to be a steal? Just multiply each plan’s monthly premium by 12 to know annual cost. Then add in your maximum out-of-pocket.

The result is the amount you’ll likely spend on health care if you had at least one significant medical expense through the course of the year, . Choose the plan with the lowest total.

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