While choosing the best insurance plan for yourself or your family members gets a bit complicated as there are numerous plans and policies. But the work gets simpler by comparing the plans in the marketplace. Finding the best way to buy health insurance can be easier if you go through the four metal categories of health insurance plans like bronze, silver, gold and platinum, as these categories show how you and your plan share costs. The plan categories generally have nothing to do with the quality of care. Suppose you compare the total prices for health care. In that case, you can get the best way to buy health insurance.
You pay a monthly premium to your insurance company even if medical services weren’t used that month. Choose to pay the out-of-pocket costs, including a deductible. It is indeed essential to think about the kinds of expenses while shopping for a plan. There are plan, and network types like HMO, PPO, POS and EPO, where these plan types allow you to use any doctor or health care facility, and the others limit the choice or might charge you more if you use providers outside of the network.
Best Way to Buy Health Insurance
There are catastrophic health insurance plans that have low monthly premiums and high deductibles. This health insurance may be an affordable way to protect yourself from the worst-case scenarios. The people eligible to buy this plan should be under 30 years of age and have a hardship exemption. If you qualify for this catastrophic plan, you can see them displayed when you compare the plans in the marketplace. The catastrophic monthly premiums are usually low, but you won’t be eligible to use a premium tax credit to lower your cost. If you are qualified to get a premium tax credit based on your income, a bronze or silver plan can be a better choice. This plan covers the essential health benefits like other marketplace plans. Like other plans, the catastrophic plan covers preventive services at no cost.
Though there are various types of marketplace health insurance plans designed to meet the needs, some plans might restrict the provider choices. Following are some examples of plan types that you might find in your marketplace-
Exclusive Provider Organization (EPO)
- This is a managed care plan where the services are covered if you use doctors, specialists or hospitals except in emergency cases.
Health Maintenance Organization (HMO)
- This is health insurance plan limits the coverage to care from doctors who are working for HMO. They provide integrated focus and care on prevention and wellness.
Point of Service (POS)
- In this type of plan, you pay less if you are using the hospitals or doctors or other healthcare providers that belong to the plan’s network.
Preferred Provider Organization (PPO)
- In this type of plan, you pay less if you use providers in the plan’s network. Doctors, providers or hospitals outside the network area can be used without any referral for an additional cost.
There are undoubtedly some diplomatic ways to pick a better health insurance plan if you understand the four metal categories better and the types of health insurance plans and networks like the EPO, HMO, POS, and PPO. But while choosing a plan, it’s better to think about the total costs related to health care and not only just the bill or premium you pay. The out-of-pocket costs impact the total spending of health care, which becomes more than the premium itself at times.
The deductibles are the cost you need to spend for covered health services before the insurance company pays any amount. The copayments are the amount of payment you pay each time you get a medical service after reaching the deductible. And out of pocket maximum are most of the amount that you need to spend on covered services in a year, and once you get this amount, the insurance company pays 100% for covered services. Following are the ways to find a category for yourself which suits you better-
If you aren’t expecting to use regular medical services or take common prescriptions, you may want to take the bronze plan. The bronze plan has low monthly premiums, but they have high deductibles, and when you need care, they pay less of your costs.
If you are qualified for the CSR, i.e. cost-sharing reductions, you may take the silver plan as it will provide better value. If you aren’t eligible for CSR, you may compare the premiums to find the right plan. If you are qualified, the deductible will be lower, and you will pay less each time you get care. Don’t forget that you get these extra savings only when you enrol for the silver plan.
Gold or platinum plan
These plans have higher monthly premiums, but they pay more of your costs when you need care. If you are expecting a lot of doctor visits or regular prescriptions, then these plans are suitable for you.