It’s not easy to choose a health insurance plan on your own. However, if you are informed, the entire process will become much simpler. By reviewing these basics you’ll be able to choose a health care plan that suits you needs.
What is the total cost?
When you are calculating the costs you shouldn’t look just at the premium. In fact, it is recommended that you add up all the 12 premiums and then add the maximum out-of-pocket costs, including the deductible. This way you can see exactly how much you would pay if you had a medical crisis.
You can compare different plans with online services such as www.iselect.com.au. This will make it easier to see all the prices in one place and you will be able to quickly identify the best offers. When you compare prices you should also remember that sometimes a low price means fewer features. Try to compare health care plans that are similar and offer the same benefits.
Plan and network types
There are various health plans that you can find in the Marketplace. For example, the Health Maintenance Organization (HMO) will usually make you see a doctor that is inside the network and it won’t cover out-of-network care, except emergencies.
The Point of Service (POS) will allow you to use doctors, hospitals and specialists outside the network, but the prices will be higher. You will need a referral from your primary care doctor if you want to see a specialist. Exclusive Provider Organization (EPO) is a health care plan that only covers doctors and hospitals that are inside the network. Once again, exceptions are excluded.
Finally, Preferred Provider Organization (PPO) are health plans that let you pay less if you are using doctors, hospitals and specialists that are inside the plan’s network. You can also use providers that are outside of the network and there aren’t any additional costs.
The metal categories
When it comes to the plans in the Health Insurance Marketplace, there are four metal categories: Bronze, Silver, Gold, and Platinum. The quality of the care is the same, but the costs are different. For the Bronze plan you pay 40% and the insurance company pays 60% for the Silver plan you pay 30% and the insurance company pays 70%, for the Gold plan you pay 20% and the insurance company pays 80%, and finally, for the Platinum plan you pay 10%, while your insurance company pays 90%.
The monthly premiums are also different, the lowest one can be found for the Bronze category, while the Platinum one has the highest monthly premium.