Choosing the best health insurance for you and your family can be an overwhelming experience given how many options are available not only on the health insurance marketplace, but from your workplace and private insurance companies as well.
It’s important to keep in mind that there is no one-size-fits-all plan, nor is there a single company that provides the best plans.
Ultimately, the right insurance for you will depend on what’s available in your area, your health needs, your budget and other individual factors.
With that in mind, there are a few different ways that anyone can narrow down the options and choose a health insurance plan.
Considering factors such as cost, availability of services and the type of plan, it becomes more straightforward to choose the best health insurance that is right for you.
Below, learn the five the questions you should yourself ask before making a final decision on your health insurance coverage.
Where can you get health insurance?
If you work at a large enough company, chances are that your employer offers health insurance options. If not, you will have to utilize the health insurance marketplace to pick a plan.
You can, of course, still buy a plan on the marketplace if you have the option of employer-based coverage if you choose to do so.
Depending on your age, income or other eligibility factors, you may also qualify to obtain health insurance through a government program such as Medicare or Medicaid.
If you want or need to buy a plan on the health insurance exchange, be aware that the majority of states use the same federal marketplace.
However, remember that if you live in one of the following places, you will need to buy coverage from a separately-run marketplace in your state:
- District of Columbia
- New York
- Rhode Island
The quality of your health insurance plan should not be affected by where you buy it. Considering where you buy health insurance is simply the first step in finding plans to choose from.
What types of health insurance are there?
The first major decision in narrowing down your health insurance options is choosing the type of plan you want.
There are seemingly countless acronyms out there for describing different types of insurance, but the main ones you’ll encounter include:
- Health Maintenance Organizations (HMOs), which are plans in which you can generally only receive coverage from doctors who work with your plan except in an emergency.
- Preferred Provider Organizations (PPOs), which allow you to pay a lower cost when using providers within your network or pay more when visiting doctors or hospitals that are outside your network.
- Point of Service (POS), which are plans let you pay less when using in-network providers, but they require you to get a referral before you can see a specialist.
- Exclusive Provider Organizations (EPOs), which are plans in which services are only covered if you use doctors or hospitals that are in your network except in emergency situations.
Deciding what plan is right for you will depend on how you typically use insurance.
For example, PPOs and POS plans do not require you to see in-network doctors, but you will receive less expensive services when doing so.
An HMO or EPO plan, on the other hand, will only let you see out-of-network providers in an emergency situation.
Where can you use your insurance?
As mentioned above, most insurance plans have strict rules about where you can use your coverage.
When you are choosing a type of insurance, make sure the available plans include a network that you want to use. Each individual health insurance plan can have its own network.
How much does health insurance cost?
Your out-of-pocket cost is perhaps one of the most important factors to consider when choosing the best health insurance.
Federal and state marketplaces should offer an overview of your expenses, including the cost of:
In most cases, these details all affect one another. For example, a plan with low premiums will oftentimes have a high deductible, whereas plans with higher premiums may have a much lower deductible. The frequency that you anticipate using your insurance will help you choose the right plan.
What benefits does health insurance provide?
Under federal law, all health insurance plans are required to offer a few types of coverage at a bare minimum. Examples of things that are considered “essential health benefits” include:
- Doctor’s services
- Inpatient and outpatient hospital care
- Prescription drugs
- Mental health services
- Pregnancy and childbirth
Additionally, government-funded health programs, such as CHIP, assist in paying for the medical bills of at-risk children.
Some health insurance plans offer only these basic types of coverage, while others will be much more comprehensive.
If you have specific medical needs or require certain prescriptions, make sure that these are covered by the plan you choose.
Ultimately, the best health insurance plan is one that includes every medical need that you currently have and that you anticipate needing while you carry your policy.