How to find the best, low cost health insurance plan? I can’t tell you how important it is to do your homework, and in this article I’ll try to help you with some of that homework. You might think health insurance is all the same, but the devil is in the details and understanding the details may save you hundreds of dollars.
One of the first things to understand is that when you purchase health insurance, just as with any kind of insurance, you are purchasing a sort of contract that guarantees you a specific set of benefits. In order to remain eligible to receive those benefits, you pay a recurring, monthly fee which is called a premium. The premium is the insurance company’s fee for managing the risk of your need for health insurance coverage. At bottom, all insurance is risk management, and you are essentially paying the insurer to assume the risk of payment for health care.
Health insurance comes in many different forms. For example, there is disease insurance, accidental death and dismemberment insurance, catastrophic health coverage, COBRA insurance, and maternity coverage to name just a few examples. All of these, by the way, are kinds of health insurance. When you shop for health insurance you are generally presented with a variety of plans that offer different benefits and different levels of coverage. Insurance plans are the way the insurance is packaged. The plan is the “bottle” holding the wine, as it were.
Some of the more common kinds of health insurance plans are the Health Maintenance Organization, or HMO; the Preferred Provider Organization, or PPO; and the Private Fee for Service Plan, or PFFS. HMO plans are generally less expensive, but they required that you use only the doctors, hospitals, and other health care providers who have a contract with the insurance company to provide service. You are usually assigned a primary care doctor and must get a referral to see a specialist. The plan ultimately determines whether or not you can see a specialist and what services and how many of each service you may receive. If you are in relatively good health and have relatively few medical needs, an HMO might work out for you. If you have a more complicated medical history, you would want to thoroughly investigate the insurance company and specific HMO to be sure they have a reliable record of meeting patients coverage needs. Kaiser Permanente would be an example of an HMO, and Kaiser Health Care generally is generally well-known throughout the United States.
The PPO offers more latitude than an HMO. The PPO also includes a network of providers for plan members, but PPOs allow you to go out of the network for coverage, though going out-of-network is usually more expensive. The costs of PPO membership–the premiums you pay, for example–are generally more expensive than HMOs, but the level of coverage is often greater. PPOs do not require referrals to see specialists, though you do want to be sure that out-of-network providers accept the insurance and therefore accept the company’s payment rate. Examples of national insurance offering PPO plans would include Anthem Blue Cross, Humana, Aetna, Cigna, Tonik, and Wellmark.
Another common sort of managed care plan is the private fee for service plan (PFFS). The PFFS has no pre-established network of doctors and hospitals and leaves your choice of provider up to you. It is important, therefore, that your doctors agree to accept the plan’s payment terms, and that you find out before you receive services if you doctors submit claims to the insurance company. Rather than offering you a fixed package of benefits, as is the case in an HMO or PPO, your providers bill the PFFS a fee for each service you receive, and the PFFS pays for each service according to its fee schedule, or payment rate.
An important question you want to ask before buying a health insurance policy is how much your costs will be. Much of the cost of a plan will include the monthly payments (premiums) along with any deductibles, co-pays, and co-insurance. However, there is another cost to take into consideration, and that is the reliability of the company. It is important that the company live up to its promise of coverage. This is a fairly controversial issue right now and another reason to taking the time to understand the policy before you buy. A plan that looks cheap could end up costing a lot more than a more expensive plan or a different plan from a different insurance company.
Low cost health insurance is attainable, but real secret is determining the benefits you need the most and then stripping everything else out of the policy. In other words, pay for as few services as possible and then add to that the highest deductible you think you could afford to pay if the need arose. Earlier, I mentioned the reliability factor. Do not buy a policy from a company until you get some idea of its customer service record. know before you go. Should a time of need arise, you want the security of knowing that the company will live up to its agreements.
Learn more about how health insurance works and finding the best low cost insurance plan for you!