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.
When you shop for health insurance, you discover that there are many different kinds and packages. For many people, health insurance means a coverage that pays the bills for doctor visits, outpatient hospital care, and inpatient stays. However, there are other kinds as well, such catastrophic health coverage, maternity coverage, and dismemberment insurance to name just a few examples. When you search for health coverage, you find an assortment of plans each offering its own package of benefits with its own rate of payment. The insurance plan is the “package” of benefits, and the benefits describe exactly what the insurer will pay for. For this reason, it is important that you understand the package so that you know what to expect when you receive health care.
Some of the kinds of insurance plans most commonly sold are health maintenance organizations (HMOs), preferred provider organizations (PPOs), and private fee for service plans (PFFSs). The HMO, PPO, and PFFS are different ways of packaging benefits. That means that each kind of plan will pay for different kinds of services and each plan will have different payment rates. A payment rate is how much they will pay health care providers for their services. HMOs are usually less expensive but generally require you to get all of your care only from providers in the plan’s pre-determined network of doctors and hospitals. In an HMO you would be assigned a Primary Care physician, and a referral from that doctor would be required in order to see a specialist. Quite often, HMOs work better for individuals who in relatively good health and whose medical needs are not terribly demanding.
The PPO is more flexible than the HMO plan. PPOs may also be a bit more expensive than HMOs, and that is because PPOs are generally thought to give a higher level of coverage. In PPOs, you are not required to have a primary care doctor, and you generally do not need a referral to see a specialist. PPOs have their own network of contracted medical personnel but allow you to go out of the network to see doctors of your own choosing. Now, that costs you more. Before signing up for a PPO, it is important that check with your providers to determine whether they are in the network or will otherwise file claims and accept payment from that particular insurance company. Major insurance companies such as Aetna and Blue Cross Blue shield, Wellmark Blue Cross, and Humana offer PPO plans as well as HMO variants.
A PFFS plan is still a kind of managed care, but in the private fee for service plan, you go to any doctor or hospital you choose as long as they submit claims to insurance company and accept payment. In a fee for service plan, your health care providers would bill the insurance company a specific fee for each service provided. What the insurer pays is based on a fee schedule.
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 cheap ppo health insurance and finding cheap health insurance for the family.