7 Tips to Help You Choose a Healthcare Plan

Written By Alla Levin
May 14, 2018

Medicare For All: Choosing a Healthcare Plan with Health Insurance Broker

Choosing healthcare isn’t easy because there are so many options available at all different price points. Let us help you figure out how to choose a healthcare plan with these seven tips and a health insurance broker. If you struggle to choose the right healthcare plan, you’re not alone.

Most Americans have difficulty understanding the policies they’re browsing, with a whopping 80% of individuals purchasing a plan that takes more out of their pocket annually than alternative options. That’s why working with knowledgeable medicare advantage brokers has become more important than ever.

So how do you weed through the confusing terminology and decide to give you the right coverage at a fair price? We’re offering up seven tips to help you better understand your options and make the best choice available on a health cash plan.

Start with a Quick Call to Your Doctor’s Office

This five-minute call will save you a lot of time and headaches. Before browsing healthcare options or detox centers in California, call your primary care physician’s office, and ask what insurance plans they accept.

Individuals’ common mistake while shopping for policies is to assume that their doctor will accept it because a well-known insurance company offers the insurance policy. This is 100 percent inaccurate.

Every healthcare policy has a specific network that it works within, and each healthcare provider is a part of their list of networks, so it pays to make sure the policies you browse are among them.

As you make this call, inquire whether local hospitals and specialists are also included within this network. You can also call your specialists up yourself or ask the policy provider for a list of who is in their network.

Review Your Past Healthcare Expensesthinkabout health insurance brokerMedicare for all

What is it you really need out of a healthcare plan? It’s imperative you know the answer to this question before you start shopping for healthcare options.

Policies vary dramatically in deductibles, and what they cover, so you need to make sure the ones you are considering align with your specific needs. Should you need any help along the way, you may wish to talk to an insurance broker from somewhere like Bend Insurance, who can help talk you through the various policies out there and help you choose the perfect one for you.

Ask yourself:

  • How many times did you visit a doctor last year?
  • Did you have to visit any specialists?
  • Do you have any medical conditions that require regular doses of medicine, residual treatment, or regular medical visits?
  • Are you at risk for any medical emergencies?
  • What is your past deductible, and did you ever reach or exceed it?

The ratio of your past deductible versus how much you spent is critical. If you are in great health and never do more than your annual physical each year, you can accept a higher deductible.

However, if you met or exceeded that amount, it’s important to get a policy that reduces your out-of-pocket expenses as much as possible. After all, a healthcare policy should save you money–not make you spend more!

 Know the Difference Between Common Plan Types

Healthcare providers offer various healthcare options, including:

  • Health Maintenance Program (HMO)
  • Preferred Provider Organizations (PPO)
  • Exclusive Provider Organization (EPO)

Educate yourself on the difference. This will help you determine at a glance whether the policies you’re shopping for are the kind you really want. Each type has its own pros and cons. HMO’s have a very restricted network, and you’ll need a referral from your primary physician to see any specialists. Still, in turn, you receive a significantly reduced cost for healthcare treatment.

PPO’s have higher premiums than HMO policies, but they have more liberty, too. While in-network physicians and specialists will always be cheaper, you have the option to see medical professionals outside of your network as well.

You don’t need to ask your primary physician for referrals, either. EPO’s are similar to HMOs, except referrals aren’t necessary if you want to make an appointment to see a specialist. You still have a network you have to stay within, unlike PPO’s.

Know the Difference Between Bronze, Silver, Gold, and Platinum Classes

HMO’s, PPO’s, and EPO’s aren’t the only distinguishing categories for healthcare plans. Policies are also classified under different metal classes to help you distinguish the differences between how much you pay versus how much your provider pays whenever you incur medical expenses.

Here’s how Healthcare.gov breaks it down:

  • Bronze policies have you pay 40% while your insurance covers the remaining 60%
  • Silver policies have you pay 30% while your insurance covers the remaining 70%
  • Gold policies have you pay 20% while your insurance covers the remaining 80%
  • Platinum policies have you pay 10% while your insurance covers the remaining 90%

Note that plans fall under both a metal class and a plan type. This is to help you know the gist of how a plan is structured just by the name alone.

Be Clear on How a Deductible Works

Your monthly payment isn’t all that you spend when you have a healthcare policy. There are 3 expenses to consider: your premium, your out-of-pocket expenses, and your deductible.

Deductibles are one of the most important numbers to pay attention to, as it defines how much you will have to pay in healthcare services that are covered in your policy before your insurance company will offer to pay for anything.

Your monthly premium is the amount you pay each month for your policy. This does not go toward your deductible at all. Out-of-pocket maximums are the caps on how much a policyholder can spend a year on healthcare services before your insurance policy covers 100 percent of the expenses.

Medicare for all: Pay Attention to Copays and Coinsurancemedical supplement broker

 

Copays and coinsurance are both advantageous to policyholders. They reduce the cost of a medical test or appointment by reducing it to a flat fee per visit. Keep in mind that copays and coinsurance will only kick in after you’ve paid your deductible. This is why we emphasize the importance of deductibles.  If yours is high, you may have to spend more than your policy is worth before you begin reaping your insurance benefits.

Don’t Be Afraid to Consult a Healthcare Broker

Lastly, don’t be afraid to consult a medical supplement broker to help you choose a healthcare plan. These individuals are trained in understanding the plans that are available to them. They can guide you through the complicated lingo and fine print to help you choose the best plan for your budget.

Many people find peace of mind in this, as they have a knowledgeable, licensed professional to answer any questions they may have and help them weigh the pros and cons of the plans available to them.

Now It’s Time to Choose a Healthcare Plan

Now that you know the basics of choosing a healthcare plan to explore your options and make a confident decision based on your needs and budget. And if you require regular dental appointments with your Dentist in Paramus, be sure to check if the healthcare plan covers dental services.

For more tips on little decisions that can help you make better life choices, check out our lifestyle articles. You’ll find it hard to stop browsing them, from healthy living to general life tips!

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