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Pointers for Picking the Right Health Policy

The high cost of medical treatment nowadays makes health insurance a must for practically everybody. However, policies can differ radically in terms of cost, coverage and features, it’s crucial that you go through your options carefully before making a choice. There are various insurance companies and providers too, and all of these make choosing just a bit more challenging. Of course, as long as you put in some time and effort doing your homework, it can become easier.

Policy Type

Health insurance policies come in several basic types, and the following are the most well-known:

Health Maintenance Organizations (HMOs)

An HMO policy only allows you to use healthcare providers within the network. And you can only see a specialist if you have a referral from your primary care physician.

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 need a referral to see a specialist, but you can see any provider in or out of their network.

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. A low-deductible policy will be more beneficial otherwise.

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 a plan has in terms of what’s covered or not – and how much your copays will be – can also make a big impact on how useful a certain policy is for you.

Choosing the Best

Are you having a hard time choosing between to policies that both seem to be a steal? Just multiply each plan’s monthly premium by 12 to know annual cost. Now add the plan’s out-of-pocket maximum.

What you get is what you’ll likely spend for healthcare if you had at least one substantial medical expense in a year’s time Pick the plan that yields the lower number.

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