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Health Insurance

Choosing a health insurance plan may seem complicated, but once you know and understand the options it is straightforward. To make an informed decision you must first compare...

Compare health insurance plans: HMO vs. PPO vs. EPO vs. POS

  • Health maintenance organizations (HMO) - - Only covers services that are provided within their network (except for emergencies). Lower out-of-pocket costs and a primary care physician who coordinates care for you, but you have less freedom to choose providers.

  • Point of Service Plan (POS) - More provider options than with an HMO and a primary care physician who coordinates care for you, with referrals required.

  • Exclusive Provider Organization (EPO) –May help keep costs low if you find providers in the network. Usually, EPO networks are bigger than that of an HMO.  Out-of-pocket costs are higher than an HMO but lower than a PPO. Physician referrals are not required.

  • Preferred provider organizations (PPO) - Treatment can be obtained in and outside of the PPO’s network. More provider options and no required referrals, but higher out-of-pocket costs.

 

Compare out-of-pocket costs

  • You pay a Premium for your coverage, regardless of the services you use.

  • Deductibles are costs you pay before your insurance kicks in.

  • Copayments a fixed fee paid at the time of service.

  • Coinsurance on certain services — % Percentage responsibility you pay at time of service.

  • Maximums out-of-pocket (MOOP)- Maximum amount you will pay in any given calendar year. Once you’ve paid this amount, your insurance would cover all future costs.

 

Most people with health insurance get it through an employer. If your job doesn’t provide health insurance, you may obtain insurance from:

 

Market Place – Guaranteed acceptance without health questions. Has Open Enrollment from October 15 through December 15 of each year. During this time you may choose to keep your current plan or change plans for the following year. If your family income is less than 400% of the poverty level you are eligible for a tax credit that will apply to all Out-of-pocket expenses.

https://www.healthsherpa.com/?_agent_id=nadia-tupikina

Private Medical Insurance- You can also purchase health insurance through a private insurer.  They do accept applications year-round, and they can help offset costs if you have a medical emergency unrelated to a preexisting condition.

https://www.uhone.com/shop/#/census?brokerid=AA5040324