The words health insurance and budget feel like they don’t even belong in the same sentence. It’s a common understanding that health insurance costs are only on the rise. In 2018, the cost for individual coverage is as high as $440 a month or $1,168 for a family of four. What are people to do to fight against these rising costs? Everything falls back on education.
The more you know about health insurance plans and how they work, the better you’ll be able to find a plan that’s right for you. The health insurance marketplace is a complicated place full of confusing terms. Yet, that doesn’t mean you should go into the process blind. Here’s a guide to finding the best health insurance plan for your particular budget.
Introduction to Plan Types
First, let’s understand the different types of plans. This is the area that most people get confused when they first begin looking at coverage. The plan names aren’t always clear, so it’s worth learning for yourself what the individual terms mean. The type of plan you choose impacts not only how much you’ll pay for services, but also how many services will be offered to you and where.
Health Insurance Plan Types
Health Maintenance Organization (HMO) - A HMO plan requires you to choose a primary doctor that is in-network. If you want outside care, you’ll need a referral except in the case of emergencies.
Preferred Provider Organization (PPO) - With a PPO, you don’t need to stay in-network. However, in-network health providers will be less expensive.
Exclusive Provider Organization (EPO) - An EPO, like an HMO, requires you to stick with in-network doctors for lower cost care. The only difference between an EPO and an HMO is you don’t need a referral for out-of-network specialists if you’re covered under an EPO.
Point of Service (POS) - Finally, a POS plan does not require you to see an in-network provider, but it’s less expensive if you do. Under this plan, you’ll need to select a primary doctor who is responsible for coordinating all of your care.
Beyond the type of plan, you’ll also need to choose a coverage amount. These usually range from bronze to platinum. Under this system, bronze is the most affordable plan with the least amount of care covered while platinum is the most expensive with more coverage. The type of category you choose will depend on your projected health care costs. If you don’t expect to need extensive healthcare for the upcoming year, don’t choose the most expensive plan.
Where to Find Coverage
Where you’ll find the best coverage will depend on your unique situation. If you or your spouse is employed, you’ll likely find the most affordable plans directly through your employer. Because your employer will cover a portion of the cost, this helps ease the strain on your wallet. However, even if you do get coverage through your employer, you can still shop around for the best plan.
Most people who aren’t able to get coverage through their employer find a plan through the Healthcare Marketplace. Depending on your state, this might be a federal or state marketplace with plans available in your unique region.
Finally, depending on your situation, you might be eligible for a federal health insurance program. If you’re nearing 65, for example, you can get coverage under Medicare. Medicare is made up of four parts, so learn more about Medicare Part A, B, C, and D before agreeing to a plan. Finally, you can also receive care through an income-based federal program known as Medicaid if you qualify or have a disability. It’s important to understand all of your options before choosing a plan.
We can all agree that it’s essential you protect your health as you age. You never know what will happen tomorrow, so choose a plan today that makes sense for your needs. The best way to find affordable coverage is to do your homework. Learning how each plan works and what’s offering in each is key to making a strong choice you can count on.