Policy Price

Article by Jo Rosario

With so many different types of health insurance plans and restrictions out there, it can be difficult finding the best health insurance for you. Health insurance can be confusing, especially if it is your first time shopping for health insurance. You need to understand terms such as deductible, co-payments, and pre-existing conditions to find the plan that best covers your health care needs. There are a few items to look for when deciding on health insurance plans, and by considering them all you can make a good decision for yourself and your family about health insurance.

The most important thing to look for is coverage. More often than not, insurance will cover physician visits and fees. Your health insurance should also cover hospital expenses such as room and board in case you are kept overnight or longer for observation or treatment. Good health insurance should also cover surgeries and any expenses associated with surgical treatment. Beyond these typical items of coverage, health insurance plans can diverge greatly.

Do you have glasses or contacts? Then you may be more interested in a plan that covers vision – either paying for your eye exam and/or partially paying for your glasses or contacts. Though many people think that health insurance covers prescriptions, prescription coverage is actually an optional benefit. If you know that you often have prescription drugs to fill, finding insurance that offers prescription coverage may be a must. If you are a woman and plan on having or want to have children, maternity care or family planning services are also optional benefits that you may want to consider. Once you make this must-have list of optional coverage, you can begin looking for health insurance plans that give you the opportunity to add these optional benefits.

Another item you should definitely consider is if your current physicians or specialists are included in the health insurance company’s preferred provider network or if you have the opportunity to choose any physician. If you would like the freedom to choose your own doctor, traditional health insurance plans or preferred provider organizations may offer more attractive plans – though these also cost a little more.

Lastly, after researching different plans coverages, compare deductibles and monthly premiums. By researching price, as well as other health insurance options, you can make the best choices for your family.

In the United States, there are about five different types of health insurance available: traditional health insurance; preferred provider organizations or PPOs; point-of-service plans or POS; health management organizations or HMOs; and most recently, health savings accounts or HSAs. With so many types of health insurance, it may be confusing trying to figure out which one best fits your needs, so thoroughly research each and speak with a professional if you need clarification. Traditional health insurance is the one that most people think of when they think of health insurance.

You pay the insurance company a premium every month, and if you have an accident or need for health coverage, you have a deductible amount you must pay and then the insurance company picks up the rest of the bill. You often have an inexpensive office and/or prescription co-pay with traditional health insurance. With people living longer, health insurance companies began to look for more ways to reduce their costs, developing different health plans such as PPOs. PPOs are plans which will cover nearly all of your medical expenses as long as you stay within a preferred network of physicians or hospitals. This network creates a “preferred provider” list that you can choose from. Treatment outside this network of providers is covered but only at a reduced rate, meaning you end up paying more to see a physician outside the network. By limiting the physicians and hospitals covered in their network, the insurance company can control, to an extent, their costs and lower your premiums.

POS plans work like PPOs, but require you to have a primary care physician through whom you can receive referrals for specialists. If you need to see a neurologist or a dermatologist, you must first visit your primary care physician for an initial diagnosis in order to receive a referral to a specialist for a more thorough diagnosis. POS plans also have a preferred provider network, and if you choose to visit a specialist or physician outside that network, your coverage will be limited.

HMOs combine a stricter version of PPOs and POS plans. HMOs have a defined list of physicians, often much smaller than PPO networks, which you may see. You will not be covered at all if you see a physician outside your HMO network. Furthermore, you must also get a referral from your primary care HMO physician to see any specialist. However,