
The Essentials Of Health Insurance
Est. Reading Time: 1 Minute
Aside from an insurance professional, nobody else finds essential health insurance exciting. A necessary evil? Sure! Something you have to research and make some decisions on? Absolutely! But fascinating and interesting? Probably not so much.
Aside from being a dry subject, most people don’t like healthcare insurance material. It’s peppered with industry jargon that makes people’s eyes glaze over before they get halfway down the page.
While there are many articles about different healthcare options, we have aggregated here the most essential health insurance options to be aware of. We have also included suggestions as to which plan fits any given situation best.
The short answer is – the one that fits your situation the best.
Typically you can choose from a few healthcare plans either provided by your employer or in the marketplace. The advantage of employer-sponsored plans is the employer paying for the majority (or sometimes entire) of monthly insurance premiums.
Two primary plans that employers often offer are HMO (Health Management Organization) and PPO (Preferred Provider Organization). HMO usually requires smaller copays and smaller (or no) deductibles making it ideal for those in good health who only need routine appointments. The disadvantage of the HMO plan is that you will need a referral to a specialist. The PPO plan allows you to see any doctors you choose without any referral requirements; however, these plans are usually more expensive. You will also need to pay higher copays and will likely have a bigger deductible before the coverage kicks in.
Est. Reading Time: 5 Minutes
According to the Kaiser Family Foundation, about 90% of all people in the US were insured in 2016. Even so, many enroll in health plans they don’t understand. Most employers set up informational meetings. However, these meetings rarely address which plan is better for which situation.
Let’s start at the basics and talk about the plans that are available and which plan might be the best for you.
If you are a full-time, salaried employee, your employer will most likely offer you enrollment in one of their sponsored plans. Some employers offer only one plan. Others give you a choice between a few. Your employer pays the majority (or all) of the monthly premium, giving you a lower cost.
If you are eligible – enroll!
Important! You will lose any money left in FSA at the end of the plan’s yearly period. You can’t withdraw the funds.
You should also carefully choose your health insurance plan because you will have it for a year. Some people avoid going to preventive checkups to reduce the out-of-pocket cost. But, while it will undoubtedly reduce the cost at that moment, it has the potential to cost you much more if you develop a serious health condition.
Whether you are purchasing your plan through the marketplace or your employer, review the plan definitions in detail. Being familiar with how they work is half the battle in making the right decision on a plan that will work best for you and your family.
If you want to keep your current doctor and are set on a PPO plan, make sure that your doctor is considered in-network. If they are not, are you willing to pay the extra cost associated with seeing an out-of-network provider? Also, will your doctor even accept your new insurance? PPO plans can include networks such as Blue Cross/Blue Shield, Aetna, Cigna, just to name a few.
When considering the health plans, also compare the benefits and the costs (copays, deductibles, prescriptions).
Insurance Broker
As a former insurance broker for over 10 years, Olga has deep knowledge of insurance concepts and policies. She is passionate about helping others understand the insurance policies they are purchasing and find policies that suit their unique needs.
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