5 Steps for Deciding on Healthcare

It’s not easy choosing the right healthcare plan. Before you make any decision, it’s important to carefully consider all of your options. Doing this will not only help you stay healthy and alive, but protect you against financial disaster as well. You should never pay for an operation or treatment for a serious illness out of your pocket. Although it is a must to have health insurance keep in mind that there are many different plans to choose from, which can make this whole process quite confusing. The following 5 steps will make deciding on a healthcare insurance plan much easier.

Get Familiar with Different Levels of Plans

You will have various options to choose from when deciding on a healthcare plan. Note that your area may offer only a select number of plans. The ones that you’ll have the option to choose from will be divided into four categories, depending on the level of benefits they offer. There are currently bronze, silver, gold, and platinum plans. On average, the bronze level covers around 60 percent of your medical costs while you pay the remaining 40 percent. Each level covers an additional 10 percent, which lowers the amount of medical costs you pay. Platinum is currently the best insurance you can get, as it covers 90 percent of your medical costs.

Get Familiar with Different Types of Plans

Even though there are 7 different types of health insurance plans, you’ll need to learn only the four most common ones. These include the Exclusive Provider Organization (EPO), Point of Service (POS), Health Maintenance Organization (HMO), and Preferred Provider Organization (PPO).

The EPO will basically cover your medical expenses only if you’re in hospitals in the plan’s network and if you used their doctors and specialists. Nevertheless, it will still cover you at other places in the event of an emergency.

Meanwhile, the POS insurance plan is designed to reduce how much you pay to use hospitals and health care providers that are in your plan’s network. If you want to see a specialist and use this plan, you’ll need to visit your primary care doctor and get a referral. The HMO covers care from doctors who are either in contract with the organization or work for it. It will cover you out-of-network only in case of an emergency.

Finally, the PPO allows you to pay less for care from doctors and specialists that are in your plan’s network. It also enables you to use hospitals and health care providers outside of the network if you pay an additional fee. In case you choose an HMO or PPO plan, you will have minimal out-of-pocket expenses. If you want to be completely covered by your insurance, you can choose a Medigap plan, such as the Mutual of Omaha medicare supplement.

Find Your Marketplace

Now that you’re familiar with all the different levels and types of health insurance plans, you should find your state’s marketplace. Note that you can skip this step if you get your insurance through your employer and you’re satisfied with the plan. However, if your employer doesn’t offer health insurance or in case you want to get Medicare supplements, you can get them at your state’s Affordable Care Act marketplace, federal marketplace or an insurance agency.

Compare Health Plan Networks

Since your insurance plan will only be covering care from health care providers and use of hospitals in certain networks, it’s important you compare them before making a decision. In case you have a health care provider you trust, you should make sure his or her name is in the provider directories for the plan you want to choose. It’s recommended you get plans that offer large networks.

Compare Benefits

The final step to deciding on a healthcare plan is to compare benefits. It may take you some time before you get familiar with the benefits each plan offers, but the research will be worth it as you’ll know exactly what you’re covered for.

One Comment

  1. Levi Armstrong

    I’m planning to get healthcare for my whole family since it’s really a nice investment in case any of us falls ill. I like that you said I should compare various health care providers to make sure they have a large network of health care providers we can pick from. Perhaps I should contact a medicare supplement insurance advisor so a professional can help me understand and interpret medicare. Thanks a lot!

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