What is the best health insurance plan for you?

Posted on by Dr.Mike

This article is a reprint of an email article from EHEALTHINSURANCE. COM

They can be found at the following address: https://compare.ehealthinsurance.com/renew/nonffm

What is the best plan for your needs?

Each year during the Open Enrollment Period you have the chance to make sure your health plan offers the best health benefit coverage and price for your lifestyle.

FIND YOUR METAL LEVEL

METAL LEVEL   PREMIUMS  OUT-OF-POCKET COSTS   PLAN PAYS*
Bronze Plans          Lower                Higher                                            60%
Silver Plans           Moderate          Moderate                                        70%
Gold Plans              Higher               Lower                                              80%
Platinum Plans    Highest              Lowest                                            90%
Metal level plans have different amounts for monthly premiums, what you pay when using the plan (out-of-pocket costs), and what the insurance company pays when you use the plan. Depending on how often you go to the doctor or have other health care needs, you should consider factors other than just the monthly premium amount when trying to determine which plan is the most affordable for you.

WHAT IS A DEDUCTIBLE?

A deductible is the amount of money that you must pay, usually within a plan year, before the insurance company will start to assist with your medical bills. You’ll want to take into account the deductible when choosing a plan, especially if you know you have an upcoming surgery or other significant medical expense that will make your deductible important.

WHAT IS COINSURANCE?

This is a cost-sharing requirement you’re responsible for paying separate from your deductible. It’s usually defined as a percentage of your medical expenses that you (and not the insurance company) is responsible for paying when you use medical services. This is important to consider when shopping because it can significantly affect how much you pay for a medical visit and or other services.

WHAT IS AN OUT-OF-POCKET MAXIMUM?

All major medical health insurance plans cannot have an out-of-pocket maximum larger than $6,850 in 2016 on individual plans and $13,200 for a family plan. Once your deductible is met, then you’re only responsible for the coinsurance percentage until the out-of-pocket maximum is reached. Once the out-of-pocket maximum is reached for a year, your plan generally pays for all further covered health care expenses that year. Like a deductible, you’ll want to make sure that you can afford the out-of-pocket maximum, especially if you intend to use your benefits often.

*Specific plan details vary. This is not intended to be the sole source of information, or the only considerations, when selecting a plan. Read the summary of benefits and other details for any plan you select to see if the plan suits your needs. If you need assistance, a licensed agent like eHealth can help you make an appropriate plan selection.
This entry was posted in Blog and tagged , , , , , , , , , , . Bookmark the permalink.