Buying Health Insurance – Tips For Better Choice
The purchase of health insurance is a personal decision that depends on you and your family needs. The main purpose of this insurance is to help with the cost of doctor visits, hospitalization, prescription medicines and other associated expenses. You can buy medical insurance on your own, through your employer or an association. Most health insurance plans also offer individual or family coverage.
Types of health insurance
There are four categories of health insurance plans in USA.
1. HMO (Health Maintenance Organization) provides an exclusive network of doctors, hospitals and alternate caregivers. You can visit any of the doctors of the HMO insurer network.
2. POS (Point Of Service) plan provides a group of doctors, but also allows you to choose a doctor outside the group. If you decide to choose a provider outside the network, the plan may require a payment or pay a higher deductible.
3. Fee-For-Service plan allows you to choose your own care providers. The plan will cover part of the cost and you will pay the remainder.
4. PPO (Preferred Provider Organization) gives you the option to see a provider within the group plan or choose your own doctor or hospital. If you visit a doctor within the network, this will cover more services and costs will be less. If you buy health insurance through their employer or association, you can choose the plans they offer them. If you purchase an individual health insurance, you can choose individual products available for sale.
How to buy a health plan?
The following are the key points that a user must analyze from each health plan especially if you are in the process of buying a new health insurance or just want to make sure you have a plan for your needs:
– Determine your insurance needs before buy it. Use the guide points to determine what kind of health coverage would be best for you and your family. Familiarize yourself with the different types of health plans.
– What type of insurance is right for you? Determine if you are eligible to buy health insurance through your employer or an association. These plans are less expensive than buying an individual plan.
– Do you need individual or family coverage? What is more important to you: flexible provider or service cost? The costs associated with an HMO are usually minimal. The POS plan allows you to choose a provider outside the network, but you will have to pay a deductible or a higher payment.
– Compare the cost of the policies. It is recommended to check what the maximum cost you can afford in the worst case scenario. For example, if you get a serious illness. Compare the price of the monthly premium and additional costs such as deductible, copayment, and coinsurance. All these information may be available through your employer or health insurance directly.
– Consider state-sponsored plans.
* Healthy NY a basic plan available through HMOs in the state, specifically designed for qualifying small business owners and independent contractors.
* Child Health Plus provides health insurance for children or young people under 19, who are not eligible for Medicaid or no insurance. Family income does not affect eligibility for children.
– See if your preferred doctors and hospitals are in the plan. It is critical to make sure that your doctor is in the network of the insurer. In some plans is expensive to go to a doctor who is out of the network. The insurer must provide a directory of providers in your area, list of doctors and hospitals that participate in the plan.
– What is not covered? It is essential to review what is not covered in the plan. This information is written under section limits and exclusions.
– Do often you need to visit specialists? It is important to choose the best coverage plan that offers highly specialized medicines such as those used to treat cancer. An HMO will require a referral from a primary care physician before you can see a specialist. In POS plan, you do not need a referral to see a specialist within the group, but to see one outside the group. POS plans and service fees generally do not require a referral.
– Investigate the quality of service provided by the plan. Search about reviews, complaints, satisfaction surveys, and other performance standards.
Are you rejected by insurance?
Individuals seeking to enter a health plan on their own and not through an employer or association may do so in an HMO or POS at any time. An individual shall not be denied health insurance cover for medical reasons. Under “guaranteed issue” law in some states like New York and New Jersey, insurers are required to offer you a policy no matter your medical condition. If you have an existing condition, you may apply for new health insurance coverage before the expiry of your current plan. If you leave your current coverage before applying the new cover will be subject to wait up to a year for treatment.