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How To Choose The Best Health Insurance Policy Based On Your Income

Have you just started working and now shopping around for health insurance? Here is a comprehensive guide that will let you make a decision in minutes. Health insurance in the USA can be highly complicated if you have no idea how it works and what each plan entails. Though the medical facilities are world class, if you do not know how things work here, you might end up paying more than you need to, and the sum can make a big dent in your savings. In fact, a recent study showed that almost 80% of Americans chose a plan where they end up paying more than they need to. In order to avoid that, the only thing you need to do is extensive research.


More often that not, your employer will have some kind of insurance policy to cover your health costs. However, many people opt for an alternative plan if they find their employer’s plan insufficient. You can either look to exchange the plan for another one or find a new one in the marketplace which is bound to cost more though. As for exchanging, most employers pay a part of your insurance, so they are likely to choose the least expensive ones. However, if your employer doesn’t have any insurance for you at all, you can find one for yourself from the federal marketplace or state exchange. Buying it from a private insurance company is also an option. However, you should know that if you do that, you will stop getting income-based discounts on your insurance premiums.

Types Of Plans

Do you know about HMO, PPO, EPO or PPS? No? Then now is the time to learn all about them. These are nothing but abbreviations for the types of plans available. Based on your medical needs you can choose one.

Health Maintenance Organization: This is for people who want a low out-of-pocket cost and prefer to have a primary doctor who coordinates with your specialist for tests and other things. It requires you to stay in the network, but there is no restriction during emergencies. It also requires referrals.

Preferred Provider Organization: For those who need more options in terms of providers and fewer referrals, this is perfect. There is no restriction for staying within your network, but it is obviously less expensive.

Exclusive Provider Organization: Just like HMO, this one has a low out-of-pocket cost but requires no referral. Going out of network is allowed only if there is an emergency.

Point Of Service Plan: For this kind of plan, you will need a primary doctor who will take care of all your needs and order your tests as well. But you will have more provider options. Staying within the network is not mandatory but it is definitely less expensive.

When planning to get an insurance, scrutinize all the medical needs of you and your family. For example, if you do not have a fixed primary care provider, you might not want to go with the plans that always require referrals. If you want to have the freedom to choose your doctors, PPO or EPO is better. Compare all the pros and cons before you zero in on your decision.

Compare Deductibles

Based on deductibles, insurance plans can be divided into four categories. As the name Platinum suggests, this is the plan where your deductible is minimum. You pay 10%, while your insurance company pays 90%. However, it is also the most expensive plan and can cost you a lot every month. The Gold plan is where the insurance company pays 80% while you pay 20%. The ratio for Silver and Bronze are as follows: 70 – 30 and 60-40, respectively. When deciding which one is  right for you, here are a few questions you need to ask yourself:

1. How often do you have to see a doctor  – monthly or bi-monthly?

2. Do you have a medical condition that requires frequent visits to the ER?

3. Do you have a chronic disease for which you need to take medicines regularly?

4. Do you have a planned surgery coming up?

5. Are you pregnant?

If you say yes to all of the above questions, consider getting a plan where you need to pay less. Otherwise, silver or bronze will do, especially if you are in good health.

So, now you know how to choose the best health insurance plan. Of course, don’t forget to compare the rates for various companies, and also make sure they cover certain aspects that suit your needs. For example, a particular plan might be covering the cost of your medicines you need to take for your diabetes. And you are good to go! Choose wisely.

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