Shopping for a health insurance plan doesn’t have to be a tedious or complicated process. We are simplifying and highlighting the most important things to look out for when switching or enrolling in a new health care insurance plan.
When you are searching for the best types of health insurance plans you will encounter a few different types. The most common types of health insurance policies are HMOs, PPOs, EPOs, or POS plans. The kind you choose will help determine your out-of-pocket costs and which doctors you can see. Here is the most common type of marketplace plans according to HealthCare.gov:
• Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
• Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
• Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
• Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
Important things to look out for when comparing health insurance plans:
1. Summary of benefits: Online marketplaces usually provide a link to the summary and show the cost near the plan’s title. A provider directory, which lists the doctors and clinics that participate in the plan’s network, should also be available. Some benefit examples to compare and make sure are covered under your selected health insurance are things like medications, maternity services, a drug for a particular condition, etc.
2. Health plan networks: Verify that your current preferred doctors/physicians are covered in the plans in-network provider directory. If you choose to go out of network, you will typically be looking at paying a higher portion of the cost.
3. Out-of-pocket costs: Very important! This includes deductibles, copayments, and coinsurance. The total you can spend out of pocket in a year is limited, and that out-of-pocket maximum is also listed in your plan information. Typically, the lower your premium, the higher your out-of-pocket costs. Keep that in mind.
Searching for health and/or life insurance plan and don’t know where to start? We can help! Contact our customer support team for assistance in selecting and comparing health and life insurance plans: