Are you looking for health insurance? How can you know which plan will best protect yourself and your family?
Health insurance is critical for keeping your healthcare costs manageable. Most insurance plans involve you paying a monthly premium. In exchange, you’ll pay less for unexpected medical costs, such as those required if someone breaks a bone or requires surgery.
You’ll also pay less for in-network visits to physicians. You may also get free preventative care that includes screenings, check-ups, and vaccines.
How can you choose the best health insurance plan for your needs?
Let’s take a look.
- Check With Your Employer
Many Americans get health insurance through their employer. This is often a good choice because employers will help you pay part of your premium, especially if you’re single.
In fact, in 2018, the average company paid 82% of the premium for single coverage. Smaller companies, however, paid only an average of 62% for families. Larger employers paid larger 71% for those with families.
You can shop in the marketplace for insurance outside of your employer, but it will probably be more expensive.
If your employer offers different types of healthcare plans to choose from, you’ll have a decision to make based upon the unique healthcare needs of your family. It’s important to know how each option works.
- Types of Plans
You may have heard of a Health Maintenance Organization, or HMO, health plan. The advantages of this type of plan are that it offers low monthly premiums and low deductibles in the event of an emergency.
The tradeoff of an HMO, however, is that you’ll have a smaller network of physicians to choose from. There’s also no non-emergency coverage provided for doctors outside of your network. And if you want to see a specialist, you’ll probably need a referral from your primary care physician.
In a Preferred Provider Organization (PPO), you won’t need to stay in-network in order to receive medical care as you would with an HMO. Care in your network, however, is less expensive with these plans.
Your monthly payments will be higher with a PPO, and you’ll usually have a greater deductible. You can reduce costs by staying in-network as much as possible.
With an Exclusive Provider Organization, or EPO, plan, your out-of-pocket costs will be lower. You’ll need to stay in-network unless you’re dealing with an emergency. You will not, however, be required to get a referral to see a specialist.
A Point of Service (POS) healthcare plan works similar to an HMO plan. You’ll need a primary care physician who gives you referrals if you want to see a specialist.
Unlike an HMO, however, a POS plan allows you to see out-of-network physicians. As with a PPO plan, physicians who aren’t in your network will cost you more per visit.
- Do Some Comparing
Given the many types of insurance available as well as recent insurance trends, it may be difficult to settle on the best type of plan for your family.
The type of plan you choose will depend on your expected healthcare costs. A plan with higher monthly premiums but bigger coverage may be right for you if you see a physician a lot or have been diagnosed with a chronic condition.
If, however, you’re in good health and don’t see a doctor much, a plan with lower monthly premiums might be the better option.
You’ll also want to consider special services offered by each plan, such as maternity services or medications. The plan you choose may differ from that of other folks your age because of your unique health requirements.
- What if My Employer Doesn’t Provide Health Insurance?
If your employer doesn’t provide health insurance, you can take a look at your state’s public health insurance marketplace. If your state doesn’t have one, you can take a look at the federal insurance marketplace. Search for a plan with low premiums that will cover the expected needs of your family.
It’s also possible to look for health insurance through a private exchange or directly through insurers.
- Other Types of Coverage
You may have heard of a Health Savings Account, or HSA. Some plans with a high deductible will make you eligible to open these. An HSA is a tax-sheltered health savings account that is owned by the individual and can get carried over during employment changes.
Funds from an HSA can get used for paying a number of different types of medical expenses. These include deductibles, dental care, vision care, and prescriptions.
Contributions to an HSA are tax-deductible. In addition, any funds you don’t use will roll over into the next year.
A Flexible Spending Account (FSA) is similar to an HSA in that it’s tax-sheltered. FSAs, however, must be set up and owned by your employer. The funds can get used for paying for prescriptions, glasses, medical equipment, and treatments prescribed by your doctor.
An FSA can allow you to reduce your out-of-pocket medical costs. You’ll also be keeping more of your income for your own needs since the funds are not taxable.
Unlike an HSA, however, FSA’s have a limit to the amount of money you’re allowed to roll over from year to year. Depending upon your employer, you may also not have access to your FSA funds for non-medical expenses.
Choosing the Best Health Insurance Plan
With so many types of plans available, it can be tricky to know which is the best health insurance plan for your family. With a little research, however, you can find the option that will result in the lowest cost and best care for your particular needs.
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