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What Should You Consider Before Purchasing a Health Insurance Plan?

We all need health insurance at one time or another. At times the care we require is basic such as a visit to the doctor for a cold, and at other times we might need emergency care. 

Either way, it’s essential to have insurance to cover the costs that can escalate quickly if a medical condition becomes serious. It’s not an easy task to find a policy that is perfect for you. 

If you’re looking for a plan and unsure where to start, take a look at some things you should consider before purchasing.

Premium and Deductible

Your premium depends on the type of benefits included in your plan. The total cost of the health insurance policy you pay is either monthly or a full year and doesn’t have the deductible. 

Usually, the more benefits and cover you have, the more expensive the premium. The deductible is an amount that you’ll have to fork out before the plan kicks in. The category of your policy will determine how much you need to pay.

The four category payment details are as follows:

  • Bronze – the insurer covers 60%, you pay 40%
  • Silver – 70% / 30%
  • Gold – 80% / 20%
  • Platinum – 90% /10%

Of course, the best option is the platinum category since it will come into effect a lot sooner than the other plans. However, it’s naturally more expensive. Suppose you’re relatively healthy and seldom go to the doctor, then you can go with one of the cheaper ones. 

On the other hand, people with high medical expenses, such as elective surgeries, would benefit from policies with a lower deductible.

Study the Different Plans

The experts at Humana health insurance advise that you should understand the various plans available before making decisions regarding your health insurance. Each one has pros and cons with varying benefits and features. The most common ones are:

  • Health Maintenance Organization (HMO) is a type of insurance that limits services from doctors who are part of the HMO network. Some of the companies require you to reside or work in its service area to get cover. Generally, no out-of-network costs are paid for unless it’s an emergency. The program focuses on prevention and wellness.
  • Preferred Provider Organization (PPO) is a type of cover where you’ll pay less if you use selected providers within the approved network. You can use medical services outside the system, at an additional cost.
  • Point of Service (POS) offers clients a discounted rate if they use doctors, hospitals, and other health service providers that belong to the approved network. If you have to see a specialist, you’ll first need a referral letter from your primary care physician.
  • Exclusive Provider Organization (EPO) is a plan based on managed care. The services are covered if you use professionals contracted into the network. It includes doctors, specialists, and hospitals, with the only exception being emergency treatment.

Copayments

People often get a bit confused with some of the terminology included in a health insurance policy. The copayment is one such misunderstood term. It’s an amount that you need to pay whenever you go visit a medical practitioner. 

It isn’t applied towards your deductible and needs to be paid every time you need medical attention. It’s due for all services, including emergency room visits and prescription medication purchases. 

The type of plan you have will determine the sum you’ll need to pay. Typically the higher your premium, the lower your copay amount. 

Medical Provider Network

If you already have a preferred doctor and dentist, make sure that the plan covers their services. The information of the provider network is always available online. Check to see if your medical practitioners and local hospitals are covered. 

Some policies have no provider restrictions, which means the insurance will pay the doctors and specialists a set amount based on similar services. In this case, check how much they will cover. Confirm with your physician that their pricing is in line with the plan.

Final Thoughts

When we get sick or injured, we want to get the best medical care to recover as quickly as possible. Choosing the correct health insurance is vital for access to quality treatment. When researching the different types of plans available, keep in mind the premiums and corresponding deductibles. 

Choose a balance between a package you can afford and deductibles you can cover when the need arises. Learn all there is to know about the different types of policies and the benefits of each one. Choose the one that best suits your health needs now and in the foreseeable future. 

Make sure to check the copayments amount, as it’s an amount that you have to pay every time you get medical attention. Take all these factors into consideration to help you choose the ideal health insurance plan.