Affordable Care Act
How do you choose the right health insurance plan? There are a lot of options to choose from, but health insurance is complicated and shoppers often feel intimidated by the small print. Here are some basic tips to help you through the health insurance shopping process.
Under Obamacare, all major medical health insurance plans now cover the same basic suite of medical benefits. These include coverage for doctors and hospitals plus maternity care, women’s health care, pediatric care, and other items. What’s more, the Obamacare law requires all plans to provide coverage for certain kinds of preventive medical care at no out-of-pocket cost to the policy holder.
That’s good news, but it doesn’t mean that all health insurance plans cover all medical services or supplies, or cover them in the same way. For example, if you see the doctor regularly for an ongoing medical issue, you may want to consider a plan with a lower deductible. And if you take prescription drugs on a regular basis you need to make sure that the drug you need is covered at an affordable cost to you under any new plan you’re considering.
What’s more, if you have a preferred doctor or hospital that you want to keep visiting, you should make sure that these are within the insurance company’s network. Health insurance companies establish network relationships with specific medical providers and seeing someone outside of your insurance company’s network can leave you with little to no coverage, depending on your plan.
There are different types of health insurance plans available in the market today: HMO, PPO, and EPO-style plans, for example. And nowadays plans are designated by a metal level as well: bronze, silver, gold, or platinum. Understanding the differences between different kinds of plans can help you pick the right one for your needs.
When you’re ready to shop for a new health insurance plan, you have a few options. You can shop through the government-run health insurance exchange in your state, through a licensed health insurance agent, or through the health insurance company directly. Sometimes you’ll find that the same plan is available through all three options – and the price is the same no matter where you buy.
You should know, however, that there are some benefits associated with shopping through a licensed agent, like eHealth. By asking questions and understanding your needs, agents can often help you narrow down your choices and pick between plans from different insurance companies. Unlike many of the “navigators” that staff many government-run exchanges, a licensed agent can legally make personal plan recommendations for you. A licensed agent can also serve as your advocate with the insurance company should any disputes over coverage or payments arise in the future.