How to Find the Best Health Insurance

How to Find the Best Health Insurance

Your health insurance is very important. It affects everything from the doctors you see to the costs you pay for each healthcare visit, each prescription, and each diagnostic test. Without a health insurance plan – or without the right coverage – you can wind up paying thousands of dollars more in medical and healthcare costs. That’s why it’s so important to make sure you’re paying for health insurance that meets your needs and lowers your costs. Fortunately, each year, open enrollment gives you the opportunity to change your health insurance. Search online to see what options you have for health insurance this year. 

During open enrollment, which typically runs from November 1 to December 15, you can change or update your health insurance enrollment for the upcoming year. There’s no better time than right now to start preparing. If you’re looking for a new health insurance plan, search online to compare your choices and find an affordable option.

Here are the steps you’ll want to take in order to find the best health insurance for your healthcare needs and your budget.

Find a Health Insurance Marketplace or Exchange

First and foremost, you have to decide where you’re going to shop for a new health insurance plan. You have a few options, and there are multiple online marketplaces available for you to browse, search for, and compare different plan options.

Many people are able to receive health insurance through their employers. If your employer offers health insurance plans, you can look at your benefit options to see which plans are available to you and what they’ll cost. You may have just one option, or your employer may offer a few different choices.

If you don’t have access to health insurance through your employer – or you do, but you’d like to choose a different plan – you can purchase a plan through healthcare exchanges and marketplaces online.

There are a number of different marketplaces you can shop. There’s a federal marketplace available at HealthCare.gov, and there are also individual state marketplaces. Twelve states and the District of Columbia offer their own health insurance exchanges, so check online to see which marketplace is the best fit for your zip code or state of residence. To find available plans, all you have to do is enter your zip code on the HealthCare.gov website. You’ll then be sent to the right marketplace for Virginia or be able to shop on the federal marketplace.

There is one more way you can purchase health insurance. You can shop through a private health insurance exchange and buy directly through an insurance company or agent. However, keep in mind that if you opt to shop privately, you won’t be eligible for tax credits or income-based discounts on your premium costs.

Consider Different Types of Health Insurance Plans

Once you’re browsing different plan options on a marketplace or exchange, it’s time to decide what type of health insurance plan you want to buy. 

You have a few different choices. The most common types of health insurance plans are HMOs, PPOs, EPOs, and POS plans. And the kind you choose will determine everything from the premium costs you pay to the doctors you’re able to see within your plan’s network. 

Here’s a quick summary of what each plan type offers.

HMO (Health Maintenance Organization)

An HMO requires plan subscribers to see only doctors and healthcare providers within the plan’s network unless it’s an emergency. You’ll need referrals for all procedures and specialist visits, and your primary doctor will coordinate all of your care. Your options are more limited. However, HMO plans typically come with cheaper out-of-pocket costs and lower premiums.

PPO (Preferred Provider Organization)

A PPO plan gives subscribers more choices and more flexibility. You don’t have to stay in-network to get coverage, and you’re able to see doctors and specialists of your choosing with no referrals or restrictions. You’ll have more provider options available too. However, PPO plans can be more expensive, especially if you’re frequently seeing out-of-network providers.

EPO (Exclusive Provider Organization)

An EPO is similar to an HMO. You can only see in-network providers if you want your care and services covered – you can only have out-of-network providers covered if it’s an emergency. However, unlike an HMO, an EPO doesn’t require you to get a referral for specialist appointments or procedures. EPOs tend to come with lower out-of-pocket costs, but your choices can be more restricted.

POS (Point of Service)

A POS plan is a bit of a combo plan, offering benefits of PPO plans and HMO plans. With a POS plan, you’ll have your primary doctor coordinate all of your care and handle referrals; you’ll need referrals to see a specialist or have any procedures performed. However, you don’t have to stay in-network, and you’re able to see out-of-network providers at a slightly higher cost. 

Look at Health Insurance Plans’ Networks

In addition to considering which type of plan is best for you, you’ll also want to take a close look at each plan’s network. Your network determines which doctors, specialists, and healthcare providers are covered by your health insurance. And that directly affects your out-of-pocket costs and healthcare expenses.

When you choose an in-network healthcare provider, more of the total cost of your services will be covered by your insurance plan. If you choose an out-of-network doctor or specialist, you’ll wind up paying more – your insurance will cover less.

So, it’s important to look at which doctors, specialists, and healthcare providers are included in a plan’s network. Check to see if your primary care provider, frequently-seen specialists, and favorite pharmacies are included in a plan’s network. If you can’t see your preferred providers, you may not want to pay more with a less inclusive plan.

Don’t have any preference? A larger network is usually a good sign that you’ll have a lot of choices. Health insurance plans with big networks give you more healthcare providers to consider, and you’ll have options if you decide to see a new doctor or specialist. 

Think About How You Use Your Health Insurance

Next, you’ll want to think about how you use your health insurance throughout the year. The types of healthcare services you use, the prescription medications you take, and even the frequency of your visits to the doctor can all affect the kind of plan and coverage you need. 

You want to choose a health insurance plan that covers you for any health issues you might face over the next year. Essentially, you want to make sure all of your anticipated needs are met – that you can see the doctor for annual checkups or any ongoing health issues you might have.

While there are plenty of unknowns, like new diagnoses or catastrophic accidents, that could happen at any time, you want health insurance to cover your most common healthcare services. For example, if you know that you’ll need to see a specialist regularly or have bloodwork done throughout the year, you want a plan that’ll cover the bulk of these costs.

Here are some factors to consider when you’re trying to determine how you use your health insurance each year:

  • Do you take certain medications? Will you need to keep taking those medications?
  • How often did you see your primary care physician this year?
  • Do you have any health conditions or illnesses?
  • Are you planning to have a child? Will you need maternity services?
  • Do you expect to need diagnostic tests over the next year?
  • Are you covered if you travel?

Compare Different Plans’ Costs

Lastly, you can’t forget about cost. You need your health insurance plan to be affordable and within your budget. And the only way to find a plan with low costs is to compare different plans online.

To determine how much different health insurance plans will cost you, you want to look at the monthly premium first. The premium is your monthly fee for coverage – and on average, insurance premiums cost $312 per month. But this cost can vary depending on the type of plan you choose and what’s covered. On average, plan costs will be around these monthly fees:

  • $206 for catastrophic health insurance coverage.
  • $434 for bronze plans.
  • $498 for silver plans.
  • $597 for gold plans.
  • $709 for platinum plans.

But the premium won’t be your only expense. Health insurance only covers a portion of every doctor’s visit, specialist appointment, diagnostic test, and healthcare service. That means you’ll have other out-of-pocket costs.

Don’t forget to look at the costs of the following factors when you’re comparing health insurance plans:

  • Your annual deductible.
  • Copays and coinsurance.
  • Maximum out-of-pocket costs.

As you browse available health insurance plans on a marketplace or exchange, make sure to compare costs as closely as possible. It’s the only way to find a low-cost plan that also meets your healthcare needs for the coming year.