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Tips for Choosing a Health Policy

Health insurance has become necessary for just about everyone, given the high cost of medical treatments today. But policies can vary dramatically in coverage, cost and other features, so it’s important to understand and review your options well before deciding which one to buy. There are various insurance companies and providers too, and all of these make choosing just a bit more challenging. But of course, with a little research, everything is easier.

Type of Policy

There are various types of policies providing health coverage, and these are the most common:

Health Maintenance Organizations (HMOs)

An HMO policy only allows you to use healthcare providers within the network. To see a specialist, you have to ask your primary care physician for a referral.

Preferred Provider Organizations (PPOs)

While PPO health policies have networks too, but you will not be confined to their in-network health care providers, and there’s no need for you to get a referral if you want to see a specialist.

Exclusive Provider Organizations (EPOs)

EPO’s are somewhat a combination of HMOs and PPOs. You have to stick to their network, but you are free to see specialists with a referral.

Point of Service (POS)

The reverse of EPO plans are known as PPO plans, which are also the least popular of all. You are allowed to see out-of-network providers, but you need to secure a referral when seeing a specialist.

High Deductible vs. Low Deductible Plans

As a general rule, higher-deductible plans will have lower monthly premiums. Your deductible is the amount of healthcare expenses that you have to cover out-of-pocket before coverage takes over. If your yearly medical expenses are low to none, a high-deductible plan can be a bargain. Otherwise, it may be wiser to go for a low-deductible policy.

Coverage Comparisons

The two most crucial factors that dictate how good a policy will be for you, are its network and the policies for coverage. Even if you go with a plan that offers out-of-network options, using in-network providers will still be more cost-efficient. And the rules that your coverage is bound to, as well as your copay rate, are also crucial when it comes to a policy being suitable or advantageous for you or not.

How to Choose the Best

Can’t decide between two policies that both seem to be the best deal for you? Just multiply each plan’s monthly premium by 12 to know annual cost. Next, add to that your maximum out-of-pocket.

The figure you get is the most you could end up spending for health care within the year if you had at least one major medical expense. Pick the plan that yields the lower number.

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