INDVIDUAL & FAMILY HEALTH INSURANCE
Finding The Right Health Insurance For You And Your Family
Whether you are single or one of our many clients who are seeking help in choosing health insurance for your family, I am here to help. In some cases you may be enrolling in health insurance for the first time. In other cases you are unhappy with your present health insurance and are seaching for a plan that better serves your needs.
Health insurance is a vital part of ensuring the health of you and your family. It allows you to have regular check-ups with a doctor, which can help catch problems early. It provides access to emergency care in life-threatening situations. Most importantly it helps you handle unexpected medical expenses that are beyond your means to cover.
There are several things to keep in mind when choosing a health plan under the Affordable Care Act. For example, you’ll need to decide between a PPO, EPO or an HMO plan. You’ll also need to choose a metal tier level for the plan which determines the percentage of your medical expenses that will be covered. In addition, if you or a family member have specific health needs, be sure to find a plan that will cover those needs. By taking the time to consider all of your options, I can help you find the health insurance plan that’s right for you.
Which Health Plan Type Is Best For You?
Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs) are all types of managed care health insurance plans. Each type of plan has its own unique features and benefits, and it’s important to understand the differences between them in order to choose the best plan for your needs. Compare the three types below.
HMOs generally have a limited network of healthcare providers that you can choose from, and you’ll need to choose a primary care doctor to coordinate your healthcare.
HMOs usually require you to get a referral from your primary care doctor in order to see a specialist.
HMOs typically have lower out-of-pocket costs, but they also generally have less flexibility in terms of which providers you can see.
PPOs have a larger network of healthcare providers that you can choose from, and you don’t need a referral to see a specialist.
PPOs generally have higher out-of-pocket costs, but they also offer more flexibility in terms of which providers you can see.
EPOs are similar to HMOs in that they have a limited network of healthcare providers that you can choose from, and you’ll need to choose a primary care doctor to coordinate your healthcare.
However, unlike HMOs, EPOs generally do not require you to get a referral to see a specialist.
EPOs typically have lower out-of-pocket costs than PPOs, but they also have less flexibility in terms of which providers you can see.
Which Plan Tier Level Is Right For You?
Under the Affordable Care Act participating health insurance companies are required to provide plans to choose from which provide differing levels of the percentage of medical costs that are covered. These different levels of coverage are called metal tiers and range from bronze to silver to gold to platinum such that the lowest tier level covers only 60% and the highest 90% of medical expenses. If you are young, single and healthy and just buying insurance for yourself, a bronze tier plan would allow you to keep you health insurance costs low. If you are older or have frequent health treatment needs you will want to choose a higher tier plan for yourself. And if you are the head of a family you will want to choose a higher tier level since the more people who are covered the greater are the chances for an unexpected major medical expense. What is covered at a tier level in one plan may not be covered in another and that may influence your choice of which health insurance provider.
Making this decision can be difficult. We would all like to minimize what we need to pay for health insurance but we would also like to feel safe in knowing that if unexpected medical expenses arise totalling many thousands of dollars, they will put us in debt that we cannot handle.
I am here to help you make the best choices within the means you can afford.
