Choosing A Plan
Choosing between health plans is not as easy as it once was. Plans differ in how much you have to pay and how easy it is to get the services you need. Although no plan will pay for all the costs associated with your medical care, some plans will cover more than others.
With any health plan you will pay a basic premium, usually monthly, to buy the health insurance coverage. In addition, there are often other payments you must make. These payments will vary by plan but essentially are deductibles and co-payments. Typically these co-payments are before reaching your deductible which gives you first dollar coverage.
Here are some questions to ask
before purchasing a Health Plan:
- What will be my monthly cost?
- Are there deductibles to pay before the insurance helps cover my costs?
- After I have met the deductible, what portion is paid by the plan?
- What doctors, hospitals, and other medical providers are part of the plan?
- Can I choose any doctor or do I have to stay within a network (PPO)?
- What is the coverage if I go outside of the network?
- If I am self-Employed am I covered on the job?
A PPO is a Preferred Provider Organization. As a member of a PPO, you can use the doctors and hospitals within the PPO network or go outside of the network for care. If you obtain care from a medical provider outside of the PPO network, you will pay more for the service. For example, a PPO might pay 80 percent of the cost for a visit with an in-network doctor, but only 70 percent of the cost for a visit to a non-network doctor.
3 Types Of Plans To Choose From:
1. Comprehensive Plans
These plans are designed for individuals and families who want help managing their routine medical expenses plus coverage for major health care expenses. These plans usually give first dollar expenses. For example, when you go to see the doctor you would pay a co-pay of $15-35 dollars. This is paid before reaching your deductible.
2. High Deductible Plans
These plans are designed for individuals and families willing to take additional responsibility for routine health care expenses for lower premiums. For example, when you go to the doctor you would pay for your doctor visits and other medical needs, but the costs associated with this would apply towards your deductible.
3. An H.S.A.
An H.S.A. is a Health Savings Account. It is a tax-advantaged personal savings account used in conjunction with a high deductible health policy. Individuals can contribute money to this account on a pre-tax basis to set aside money for qualified medical care and expenses. H.S.A. accounts are typically High Deductible Plans. For even more information on HSA's, please visit the HSAcenter.
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