How to Choose Health Insurance: Your Step by Step Guide – Spot72.com
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Spot72.com – From understanding the types of health plans to comparing out-of-pocket costs, here’s how to choose the best coverage.
You usually have limited time to choose the best health insurance plan for your family, but rushing around and choosing the wrong coverage can be expensive.
Here’s a start-to-finish guide to help you find affordable health insurance, either through state or federal markets or through an employer.
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Step 1: Choose your health insurance market
How you shop for health insurance will depend on what is available to you.
If your employer offers health insurance
Most people with health insurance get it through their employer. If your employer offers health insurance, you don’t need to use a government insurance exchange or marketplace unless you want to find an alternative plan.
But the plans on the market tend to cost more than the plans offered by employers. This is because most employers pay a portion of workers’ insurance premiums.
If your employer does not offer health insurance
Shop your state’s online marketplace, if available, or the federal marketplace to find the plan that’s best for you. Start by going to HealthCare.gov and entering your zip code.
You will be sent to your country’s exchange, if any. If not, you will use the federal market.
You can also purchase health insurance through a private exchange or directly from an insurance company.
If you select this option, you will not be eligible for a premium tax credit, which is an income-based discount on your monthly premium.
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Step 2: compare the types of health insurance plans
You’ll find some alphabet soup when shopping for the best health insurance plan. The most common types of health insurance policies are HMOs, PPOs, EPOs, and POS plans.
What you choose will help determine your out-of-pocket costs and which doctors you can see.
Find a summary of benefits
Online Marketplaces usually provide a link to a benefits summary, which explains all the plans’ costs and coverage. A provider directory, which lists doctors and clinics participating in the plan’s network, should also be available.
If you’re going through an employer, ask your workplace benefits administrator for a benefits summary.
Consider your family’s medical needs
Look at the amount and type of care you’ve received in the past. While it’s impossible to predict every medical cost, being aware of trends can help you make an informed decision.
Consider whether you want a referral Care system
Packages that need a reference
If you choose an HMO or POS plan, which requires a referral, you should usually see your primary care doctor before scheduling a procedure or visiting a specialist. Because of these requirements, many people prefer other plans.
However, by limiting your choices to the providers they contract with, HMOs tend to be the cheapest type of health plan.
The benefit of HMO and POS plans is that there is one primary physician managing your overall medical care, which can result in greater familiarity with your medical record needs and continuity.
If you choose a POS plan and go outside the network, be sure to get a referral from your doctor beforehand to reduce out-of-pocket costs. (You can’t go off-grid with an HMO unless it’s an emergency.)
Packages that do not require referrals
If you prefer to see a specialist without a referral, you may be happier with an EPO or PPO. (EPOs usually don’t require a reference, but some do, so read the fine print.)
EPOs can help keep costs low as long as you find a provider in the network; this is more likely to occur in larger metro areas.
PPOs may be better if you live in a remote or rural area with limited access to doctors and care, as you may be forced off the grid.
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How about an HDHP with a health savings account?
High deductible health plans, or HDHPs, can be any of the above types of health insurance — HMO, PPO, EPO or POS — but follow certain rules to be “HSA qualified.”
These HDHPs usually have lower premiums, but you pay higher out-of-pocket costs, especially at first.
They’re the only plans that qualify you to open a health savings account, or HSA, which is a tax-advantaged account you can use to pay for health care expenses.
If you’re interested in this setup, be sure to learn the ins and outs of HSAs and HDHPs first.