A key aspect that differentiates those who are inattentive when it comes to selecting their healthcare plans, and those that select a quality healthcare plan that is accessible and accommodating of their needs, is careful preparation and planning. You want a health insurer that is transparent about which doctors and which type of specialists take your insurance, the cost of procedures, as well as provide information about the quality of care from specific hospitals or physicians.
Before you can select the best health insurance, you will need to familiarize yourself with the “metal” categories.
Bronze insurance plans will cover about 60% of your medical costs, and you will have to pay the rest. With Silver, the insurance company will pay 70%. Gold will pay 80% of medical expenses, while Platinum will pay about 90%. While the Platinum might look the most attractive for those who want comprehensive coverage, realize that it comes with the highest monthly premiums. This plan is ideal for those who have the means to have the most comprehensive care.
As you go from Gold, Silver, and to Bronze, monthly premiums will become lower, but costs will increase when you do need medical care. Other factors come into play also when it comes to how much you will pay. For example, no matter which category you look into, you can save money on monthly premiums if you are considered low income. You can also save on your monthly insurance bill with the help of tax credits that you may be eligible for.
Finding Your Marketplace
While most people obtain healthcare plans via their employer, some might want to invest in the government insurance exchange, or the marketplace. Keep in mind that if your employer offers health insurance and you still want to go out of your way to pick a health insurance plan from the marketplace, the cost may be a lot more since employers pay a portion of your premiums. To tap into the marketplace, check out the official page where you will be able to shop your state’s Affordable Care Act marketplace.
Once in the marketplace, you will be met with a litany of letters, with most being POS, HMOs, PPOs, or EPOs plans. If you want to lower out-of-pocket cost, then select an HMO plan type. You will be able to stay within your network and be eligible to go outside the network in the case of emergencies. HMO tends to be more affordable and convenient since the primary doctor will be able to coordinate your care, including working in tandem with adjacent specialists. EPO and PPO also offer a variety of plans, with the former offering no required referrals but lower costs and the latter offering additional provider options and no required referrals.
Comparing Your Out-Of-Pocket Costs
Any plan that you perused will have a summary of benefits that will lay out how much you have to pay for out-of-pocket services and expenses. This is why it’s particularly important to be familiar with the type of vocabulary that these marketplaces and health insurance companies use. As a consumer, you will need to understand what deductible, co-payments, and coinsurance mean. Generally speaking, lower premiums equals higher out-of-pocket costs.
- Deductible. This represents how much money you will pay before your health insurance covers the rest of your bills. For example, if you have a $1200 deductible, you must pay $1200 out of your pocket before your health insurance covers your other costs.
- Co-pay. This is a decided rate you pay for health care services.
- Coinsurance. Coinsurance is a percentage of a medical charge that you have to take care of out-of-pocket, with the rest being paid by your health insurance plan. For example, if you have a 30% coinsurance, you pay 30% of the medical cost before your health insurance covers the remaining 70%.
How much coverage will you obtain? Your health insurance plan will boil down to two classes of costs. A health insurance plan that will cover a greater portion of your medical bills will have higher monthly premiums. This is ideal if you see a physician frequently, you may need frequent emergency care, you take expensive brand-name medication regularly, you’re planning to have a baby, or you have planned surgeries queued. A plan with e higher out-of-pocket costs but lower monthly premiums is ideal for those who are in generally good health, who may not need to see a doctor frequently. Contact us today if you need help with finding a health care insurance plan.