What to Look for When Choosing a Health Insurance Carrier

When it comes to making a decision as important as choosing a health insurance company on the Affordable Care Act marketplace, it warrants some careful consideration and research.  With complex terminology like “premiums” or “deductibles,” things can get very confusing very fast.  But hopefully, some of the tips here will help you find the right insurance company with the right plan for you.

When evaluating a health insurance company or plan, you should look at 3 main things:

What type of insurance plan do you need?

There are a few different types of plans that would be better for you depending on what you need:

  • HMO (Healthcare Maintenance Organization): with these plans, unless it’s an emergency, you have to stay within the network to get coverage. You also need a referral if you want to see a specialist.  This is a good plan for you if you want lower out-of-pocket costs and a primary care doctor that coordinates your treatment.
  • EPO (Exclusive Provider Organization): these are pretty much the same as HMO’s but you don’t need a referral to see a specialist.
  • POS (Point of Service): with these plans, you are not required to stay in-network for coverage, but it will be cheaper if you do. If you want more care options but still want a doctor to coordinate your treatment, this is the plan for you.
  • PPO (Preferred Provider Organization): these plans are the same as POS’s but you don’t need a referral to see a specialist.

Does your plan cover your doctor?

If you have a doctor you’ve been seeing and would like to continue seeing them, make sure they are on the provider list for the plan/health insurance carrier you’re considering.  Not all doctors will accept all health plans.

If you like options, you should also make sure that your plan has a vast network of doctors in your area.

What are my costs?

Usually, the more medical costs the plan covers, the more expensive it will be.  Depending on how often you see the doctor, this can be a good thing or a bad thing.

If you can afford it, you should consider a plan that covers a more significant percentage of your medical costs if you see the doctor frequently, take prescription drugs on a regular basis, have a surgery coming up, or have a chronic medical condition. Usually, the more the plan costs, the lower your out-of-pocket expenses will be.

Also be sure to look at the “Summary of Benefits.”  Some plans might cover more physical therapy, mental health treatments, prescription drugs, or emergency room costs than others.

Still not sure?

If you’re still not sure about which health insurance plan or carrier is right for you, get in touch with the health insurance experts at HealthcareInsurance.Company. Or, call (855) 401-8383 to speak with a licensed Obamacare agent who can help you pick the right plan and get you the best prices with no obligations or strings attached.