Picking the right health coverage makes a difference in your family’s physical and financial wellness. Since
open enrollment only falls during a limited time, you need to review critical factors to make an intelligent decision. Consider facts you should remember when selecting a health plan and suggestions for finding a health insurance broker who can help.
Receiving Guidance From a Health Insurance Broker
A health insurance broker is an excellent resource to help you compare plans from different carriers, find the coverage that best suits your needs, and negotiate better rates. A broker can also give you access to a broader range of options than you can find alone.
The agent is familiar with the underwriting process and can help you avoid any pitfalls that could result in your application being denied. You will have help understanding the complex language of insurance policies and riders and clearer explanations about how different plans work. While you can technically
find health insurance on your own, working with a health insurance broker ensures you have someone in your corner looking out for your best interests.
Selecting the Right Kind of Plan
Many different types of private health insurance plans are available, and it can be difficult to understand the difference between them.
EPO, PPO, and HMO plans are all popular options, each with distinct advantages.
An EPO, or exclusive provider organization, is a type of health plan that contracts with a specific network of doctors and hospitals. Members of an EPO plan must use providers within the network to have coverage. These plans typically have lower monthly premiums but more limited coverage.
A PPO, or preferred provider organization, is another type of health plan that contracts with a specific network of doctors and hospitals. However, unlike an EPO, members of a PPO plan are not required to use only in-network providers. An individual can receive coverage for out-of-network care, but the treatment may be subject to higher deductibles and copayments. PPO plans typically have higher monthly premiums than EPO plans but offer more flexible coverage.
An HMO, or health maintenance organization, is a managed care plan offering comprehensive coverage for medical and preventive care services. HMOs usually require members to select a primary care physician from within the network who will coordinate their care. These plans usually have lower monthly premiums than PPO or EPO plans but may have more restrictive coverage.
Choosing the Correct Coverage Tier for Private Health Insurance
You have a choice between Platinum, Gold, Silver, and Bronze plans. While you might assume that Platinum must be the best for you, determine which program offers you the best balance between out-of-pocket costs and premiums. While Bronze has the lowest monthly premiums, the higher copays and deductibles can be prohibitive. The correct tier depends on your circumstances, and many folks are happy with
Silver coverage, which offer cost-sharing reductions.
Considering Your Current Care Team’s Network
A plan may look like the perfect fit, but you should consider if it includes your current care team in the network. On the other hand, moving to a network with a more extensive selection can offer you greater access to health care. A change could be better for your well-being.
Reviewing Your Total Benefits
All plans cover catastrophic issues and certain essential needs. However, if you have a treatment or preventative service you want to cover, verify that the programs you are considering include those items. Prescriptions are another critical consideration. View the drug coverage to see if your current medication is on the list and how much your costs would be under a new plan.
Finding Health Insurance Broker Who Is on Your Side
You don’t have to go about the process of finding quality coverage alone. For expert guidance on finding insurance that meets your needs, contact us at
Sackett & Associates Insurance Services. A qualified health insurance broker will assist you in making a wise choice.