Shopping for Health Care Insurance

 

Often times, people are hesitant to shop around for health care insurance, assuming that it will be a hassle. But finding the right plan for you or your loved ones is an important task. There are many variables that come into play when deciding on a health insurance provider, but there are some general guidelines that anyone can follow to find their way to the right plan.

First, you have to understand a few key terms. A health management organization, or HMO, provides patients with health care coverage in a certain network of doctors. Often you choose a primary care physician in this network, and they will refer you to specialists as necessary. It is important to check which doctors are covered under the HMO network, as out of network visits can get expensive. Exclusive Provider Organizations, or EPO, are similar to an HMO plan but include a nationwide network. Point of Service, or POS, are also basically HMO plans but allow you to see out-of-network physicians more regularly. A preferred provider organization, or PPO, grants more flexibility to the patient as it includes a network of physicians and specialists who have worked out a negotiated rate with the insurer, but often there are higher copayments and other costs associated with this.

Often people focus on the annual deductible or cost of copayments when selecting an insurer, whether a private one or one through your job. Deductibles are paid in order to receive your coverage, discounts, and benefits. It can range from a couple hundred to a couple thousand dollars, and must be paid every year for your benefits to kick in. Copayments, copays for short, are paid in order for you to see a doctor, and usually range from about $10 to $50. It is also important to note your out-of-pocket maximum. That is, most plans have a certain amount that is the most you would have to pay, regardless of the medical bills. You should also check to see if the plan has a prescription drug program that will help set low costs for prescriptions regardless of where you get them filled.

When comparing all of these factors, things can sometimes get tricky, but it boils down to deciding what is most important to you: overall costs, hassle to get things done and paid for, or having more choices when deciding where you want to go.