Shopping for health insurance may be one of the important purchases a family can make. There are many considerations and a lot of things to learn before signing the policy and paying that premium.
Here is a list of some basic research to get the shopping started.
*research the companies offering insurance, make sure they are solvent, check for law suits and complaints
*learn the different types of health insurance that are available
*understand how you will be reimbursed for services or if there will be a co-pay system
*check for pre-existing rules and conditions
There are some general terms that are helpful to understand when shopping for health insurance.
Health Maintenance Organizations (HMO)
This is a plan that provides patients coverage with in a network of doctors. The plan works well if the doctors in the network are accessible and work well for the patient. If there are specific doctors outside the network the patient wants, and HMO may not be the best choice.
Typically a Health Maintenance Organizations rewards patients for preventative care and preventative health care comes at a very low cost. For example, a yearly physical may just be the cost of the office visit. The labs and testing are all covered by the insurance.
Exclusive Provider Organization
This is an HMO with a national network option as opposed to a regional program.
Preferred Provider Organization
This plan has a network of doctors and within the network works like a health maintenance organization. Using the doctors and services outside of the network does not require a referral, but is covered at a lower percentage rate. For example, inside the network may cover 90% while outside the network covers 70%.
Catastrophic/ High Deductibles / Safety Nets Plans
There are many different names for these types of coverage. Their basis purpose is to serve those who are overall healthy, but need coverage in case of a major medical event.
There are some other options that are not insurance plans, but do help to cover medical bills. It is important to understand these. They may be a great part of an overall plan.
Health Savings Account
Money can be set aside up to $2,850 per person or $5,650 per family. It can be taken out of the pay check pre-tax. This money carries over year to year.
Flexible Savings Account
This is similar to the health savings account, but the money put into the account must be used by years end.
Now with a clearer picture of what the terms and differences are, it is time to get personal. Examine the specific needs and health conditions of you and your family.
Take a look at the medical history and calculate the odds. For example, Sue’s maternal grandparents both passed away of heart attacks and her mother has a pace maker. Her paternal grandfather had colon cancer and her paternal grandmother died of ovarian cancer. This information alone is enough to warrant more than just a safety net plan.
Medications are expensive and it has to be an important part of the consideration.
Remember purchasing medical insurance does not require a good sales person. It requires research and common sense.