Tuesday, December 21, 2021

The Importance of the Right Health Insurance

Everyone cares about their family’s health. Unfortunately, healthcare isn’t cheap. It’s easy to build up medical debts, especially if you’re uninsured or if your insurance doesn’t cover the care that you or your family needs. 

While finding the right health insurance won’t solve all of your money problems, it can help your family to receive better care when they need it. Here are some reasons why the right health insurance is so important and what to look out for when looking for an insurance plan.


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Health Insurance Matters

If at all possible, you should get health insurance for your family. Health insurance is important because it allows you to get the right medical care when you need it. You never know when you might need to go to the emergency room and, without insurance behind you, you could end up saddled with a horrendous amount of debt. 

The financial burden of being uninsured can get worse as some states have begun enforcing tax penalties for being uninsured. This had been enforced federally until 2019, so it does depend on where you live. 

Not only that, but you may get higher quality healthcare if you’re insured. However, you should always ask detailed questions about what kind of care is on offer and how much it will cost. While you want the best treatment possible, it’s worth asking about alternatives. 

But health insurance gives you these options. In 2018, 8.5% of Americans didn’t have any health insurance. That’s around 27.5 million people. According to a report by the CDC, one in five of these uninsured people skipped treatment because of how much it cost. Or, to put it in numbers, 5.5 million people skipped vital healthcare treatments because of the cost. 

In some cases, this can result in additional debts as a lack of treatment results in a chronic condition. If a diagnosis isn’t caught early because you couldn’t afford a test, for example, you might be saddled with that health condition and the costs of treatment for years. Some people have died because of this cost of treatment.

As you can see, health insurance can be a huge deal for your family. It stands to reason that the type of health insurance that you choose also matters.

How to Pick the Right Type of Health Insurance Plan

Often, a health insurance agency will guide you through finding the right plan for your circumstances. This is incredibly helpful as they will know all the ins and outs of health insurance plans and can find something that is affordable and covers your needs. 

You can get health insurance through your employer, which many people do. If this is the case, make sure that you have the details of your workplace’s health insurance policy so that you know exactly what your insurance covers. Even if your employer offers health insurance, you can still shop around if you have specific needs that aren’t covered in their plan.

The Affordable Care Act, established in 2010 and otherwise known as Obamacare, is designed to make health insurance plans available for everyone. It also covers preexisting conditions and preventative care, making it a great help to many families. You can enroll each year to see if you qualify for it. 

This is where picking the right health insurance plan comes into the picture. Different plans have different levels of coverage and may have different requirements. There are four main types of health insurance plans to choose from:

  • HMO (Health Maintenance Organization): This plan requires you to stay in a set network to get coverage, except for emergencies. Procedures and specialists require a referral. So, while you have lower out-of-pocket costs and a doctor who can coordinate your care for you, you do have less freedom to choose your healthcare providers.

  • PPO (Preferred Provider Organization): This plan doesn’t require you to stay in your network (although it’s more expensive outside of the network) and you don’t need a referral for procedures and specialists. So, you get more freedom, but higher out-of-pocket costs.

  • EPO (Executive Provider Organization): You again have to stay in your network, outside of emergencies, but you don’t need a referral for procedures and specialists. It’s cheaper, but you’re restricted again with your healthcare providers.

  • POS (Point of Service Plan): You can get coverage outside of your network, albeit at an increased cost, but you do need a referral for procedures and specialists. So, you have more provider options, and your primary doctor coordinates your care and any needed referrals. 

As you can see, a network is a huge part of your health insurance. Essentially, this network includes doctors who take your chosen health plan. So, if you have a preferred doctor, make sure that they’re in the network of your plan by asking them or checking the provider directories. Pay a lot of attention to these directories, as some plans might not have any in-network doctors close to you.

Your Family’s Needs

Every family is different and your family may have specific needs that better suit a certain health insurance plan. Again, an agency can help you out with this, but there are a few things to consider. 

First of all, you need to make sure that the healthcare network includes local doctors. If it doesn’t, then don’t go for that plan. You should also look at what you can afford. This includes the premium, which is what you pay each month, and out-of-pocket costs. Out-of-pocket costs are what you’ll have to pay out of pocket for services. 

Usually, the lower the premium, the higher the out-of-pocket costs. If you regularly need medical care, you’re likely better off going for a high premium plan as it will save you money in the long run. 

You also need to look at the benefits and what’s covered by your plan. If you have a preexisting condition that requires medication or regular treatments, make sure that it’s covered under your health insurance. Some plans also have a wider scope of services or better emergency coverage. 

1 comment:

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