Let’s start with the basic terminology with health medical plans (health insurance). There are three basic coverages to a plan, the deductible and coinsurance (coins) and the frequently used copay. I will explain them below.
Deductible: This is what you pay out of your pocket before the insurance company pays any claims. Deductibles are on an annual basis and reset every January first. This is similar to your car or homeowners insurance policy.
Coinsurance: Once you meet your annual deductible, the insurance company shares some expenses with you until you reach your annual maximum out of pocket. Plans are written as 80/20 plans or 90/10 plans, they always add up to 100%. This is not unlimited there is a stop loss for you.
Co-pay: A co-pay is the amount you pay for a visit to the doctor (HMO or PPO plans) or a pharmacy prescription plan. The copay has nothing to do with the annual deductible and not all plans have co-pays.
What should a family look for when buying health insurance?
If you see the doctor a lot or your children frequently need a doctor’s care you may want a Health Maintenance Organization (HMO) plan. An HMO is a type of plan that has a network of doctors and facilities that you must go to for health care. Your health insurance company will have a list of doctors for you to choose from and the doctor you choose is the doctor you must go to when you feel sick. You the patient is responsible for when you visit a health care facility with a co-pay, this is good for an individual or family with children that need to see the doctor many times in a year.
If you’re a person who does not go to the doctor a lot except for a checkup, you may want a PPO plan. These insurance plans have a network of providers that you can go to receive health care at a discounted or negotiated rate. Although there is a network of doctors who agree to the negotiated rate not all do and these are considered out of network. A PPO health plan allows you to go to out of network doctors but you will be responsible for the higher non-negotiated cost of health care.
The greater the insurance coverage, the higher the premium that you need to pay for individual and family health insurance.
Buying Health Insurance Online
The internet is a powerful way to shop for insurance. Most health insurance quotes from websites will let you run comparisons of all types of plans from all the top health insurance carriers. You can search and purchase insurance online without the need to talk to an agent. The prices for insurance plans are state mandated and no one website can give you a better quote than another. Buying direct from the insurance company won’t save you money either, everybody has the same price. Working with an agent gets you free advice and helps you sort out plans that are best for you. So shop online, there is no obligation to buy and you can complete applications right online.