Your Personal Guide To Choosing The Right Health Insurance Plan

Health Insurance!

In all our years on this planet, the one thing that we’ve learned is that our health should always be our #1 priority. 

And there’s only one thing that’ll really help you out if you fall sick or happen to be in an accident.

And that’s “Health Insurance.”

If you ask us, each and every one should have health insurance.

And if you don’t, you should buy one right now. 

 Well, we understand that you might obviously be confused. 

Many questions will be flourishing in your mind. Some of the questions might be:

  • Which health insurance company should I choose?
  • Which plan is the best for me?
  • How can I get a discount?

Don’t worry! You aren’t alone.  

And that’s why we are here to help you.

In this blog post, we will help you understand which health insurance plan will be the best for you and how you can choose the perfect one for you and your family. 

Without wasting time, let’s just get started right away!

Health Plan Marketplace! Choose One!

In most cases, your employer might provide you with a health insurance policy. 

And if you already have one, there’s no need to use the government insurance marketplaces. 

What if you want to choose an alternative plan listed in the exchanges instead of the one provided by your employer?

Image result for federal marketplace

Well, you can definitely do that. 

There are even chances that your employer doesn’t even provide you with health insurance.

What should you do in such cases?

The first thing that you should do in such cases is going to your state’s public marketplace and buy one.

You can simply visit www.healthcare.gov and enter your ZIP code. 

Note: Don’t miss the open enrollment period, which runs from November 1st to December 15th. 

Once you enter the ZIP code, you will be redirected to your state’s exchange. 

Don’t worry if there’s no marketplace for your state. 

You’ll be redirected to the federal marketplace. All enrollees in the state of Florida will use the Federal Marketplace.

OR

Other options involve buying health insurance directly from an insurer or through a private exchange.

BUT! And that’s a big BUT!

If you choose any of the other two alternate options, you certainly won’t be eligible for the premium tax credits. 

Which Health Insurance Plan Should You Choose?

Image result for hmo ppo pos epo

These are the most common health insurance plans:

  • Health Maintenance Organization (HMOs)
  • Preferred Provider Organization (PPOs)
  • Point of Service (POS)
  • Exclusive Provider Organizations (EPOs)
  • High-Deductible Health Plans (HDHPs)

Which one should you choose?

The plan you choose will decide which doctors you can visit and how much additional costs you need to pay. 

And that’s the reason we have prepared a short and sweet summary just for you.

Type Of PlanDo you need to stay inside the network in order to get coverage? Is a referral required? Snapshot
Health Maintenance Organization (HMOs)
Yes! However, in case of emergencies, you can visit any doctor out-of-the-networkYes!Less freedom to choose your providers. Less out-of-pocket costs.A primary doctor will take care of your care. 
Preferred Provider Organization (PPOs)
No!However, in-network care is comparatively expensive.No!Comparatively more freedom to choose the providers.No referrals required. Comparatively higher out-of-the-pocket costs.
Exclusive Provider Organizations (EPOs)Yes! However, in case of emergencies, you can visit any doctor out-of-the-networkNo!Less freedom to choose the providers.No referrals required. Lower out-of-the-pocket costs.
Point of Service (POS)
No!However, in-network care is comparatively expensive.Yes!Comparatively more freedom to choose the providers.A primary doctor will take care of your care.Referrals required. 

Didn’t get what you needed?

Don’t worry!

We have covered the different kinds of medical plans in detail.

You can check out the blog post right HERE!

Compare The Plans

What did you learn from the above summary?

The one thing that we learned is that if you decide to go with an in-network provider, you’ll have to pay less comparatively.

Why?

That’s because the health insurance companies contract lower prices with the in-network providers.

However, if you just go looking outside the network, then you will have to pay comparatively more. 

Image result for local doctors in network

And that’s because the health insurance companies don’t already have a fixed rate with the out-of-the-network doctors. 

Already have some preferred doctors? Want to keep visiting them?

Make sure that they are already in the provider directories. 

You can directly contact the doctor to know more.

Don’t have a preferred doctor?

Well, you should go with a plan that will provide you with more choices in your hands. 

Why is a more extensive network important?

That’s because you will be able to find a local doctor that will be able to check you. And that’s true, especially in rural areas.

Check out whether the names of the local doctors are already in your in-network doctors. Eliminate the plans that don’t already have their names.

Out-Of-The-Pocket Costs! Compare Them!

And that’s the one thing that’s really important when it comes to choosing a health insurance policy. 

They are equally important. 

Image result for out of the pocket costs

When you check out the summary for each and every plan, you’ll be able even to take a look at how much you will be required to pay out of your pocket.

If you take a look at the federal or state marketplaces, you’ll be able to see a snapshot of the costs of the different plans.

You can directly compare at the marketplaces itself. 

We would advise you to get yourself familiar with three important terms:

  • Deductible
  • Co-payments
  • Coinsurance

Remember this!

The lower your premium is, the higher you will have to pay out-of-the-pocket. 

Once you are able to compare all the costs, you’ll have a clear understanding of which plan to go with. 

What’s the end-goal of this blog post?

This blog post will help helping you understand better on which plan is the perfect one for you out of the different health insurance plans available in the marketplace.

And you can just do that when you compare the out-of-the-pocket costs of the different plans. 

Let’s just suppose that a plan pays a right amount of portion of your medical costs.

Image result for out of the pocket costs

However, the monthly premiums are comparatively higher.

Will it be best for you?

This plan will only be best for you if:

  • You visit a primary specialist or a physician on a regular basis.
  • You buy expensive brand medications regularly.
  • Emergency care is frequently needed. 
  • Major emergency surgery is scheduled.
  • You are currently expecting a baby.
  • You’ve been diagnosed with a condition like cancer or diabetes. 

And you should consider buying the above plan only if you fulfill these conditions.

And if you don’t.

We have another plan in mind. 

Let’s just suppose that the out-of-the-pocket costs are higher.

However, the monthly premiums are comparatively lower.

You should consider buying such a plan only if:

  • You don’t visit a doctor regularly and are in good health. 
  • Can’t afford a monthly premium plan that charges high.

Benefits! Compare Them!

What’s in it for you?

What are the benefits of your health insurance plan?

By now, you already would have eliminated some of the options. 

Let’s just eliminate some more out of the list. 

How can you do that?

It’s simple!

Image result for health insurance plans benefits usa

All you need to do is to compare the benefits offered by the different plans. 

Some might have better coverage for fertility treatments, mental health care, physical therapy.

While some might not.

Instead, some plans might have better emergency coverage.

Obviously, you can’t ever predict the future.

However, you need to understand what’s best for you. Depending on that, you can eliminate some of the options in your list and choose a plan for you that’s JUST PERFECT!

Once you are able to eliminate further few options, it’s time that you asked your agent some questions. 

You can directly contact your agent.

OR

You can call the customer support line. 

Before you contact them, you should note down a few questions:

  • What will happen if I get sick while traveling abroad?
  • Which maternity services are covered?
  • I already take a specific medication. Let me know more.
  • Which drugs are actually covered under this plan?
  • How should we get started? Which documents are mandatory?

NOTE

Immediately discontinue your old plan (If you already have one.)

Conclusion

Related image

Let’s take a look at the quick recap of what we learned above. 

  • Visit the state or federal marketplace. View all the plans side-by-side in order to have a better understanding.
  • Which plan is the best for you? Here are your options:
    • HMO
    • PPO
    • POS
    • EPO
  • Eliminate the plans out of your list if they don’t have any specific or local doctors in the provider network.
  • Compare the costs
  • Lastly, learn what’s in it for you. Learn about the benefits that the plans have to offer. Make sure to note down some questions before you make your decision. 

Questions? You can always reach out to us at Star Nsurance. We are available by phone at 813-563-5577. You can also stop by our office at 1430 E Fletcher Ave. Tampa, FL 33612. After hours? Contact us on our website HERE. We look forward to assisting you with your Health Insurance needs.

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Contact Star Nsurance today to get a FREE insurance quote.

Call 813-563-5577. Se habla español.