SunGate Insurance Agency Blog
It may sound tricky to navigate through the health insurance landscape and the truth is, It is. This guide will help you get started choosing the best plan for you and your family.
1) Look for your marketplace
Most employed people can get health insurance from their employer. You don't need to utilize the government insurance marketplace or exchanges if you are one of them.
Even if your employer provides health insurance, you may still want to look for an alternative plan in the exchanges. However, the plans in the marketplace may have a higher cost. Most of the employers that provide insurance for their workers pay a portion of their premiums so they usually offer the option that is least expensive.
If there is no health insurance benefit from your work, contact an independent agency with specialists in health insurance to find out the best options available to you and your family.
It is possible to buy health insurance directly from an insurer but you’ll pay the same price as if you work with an independent agent who can offer you more options.
2) Compare the different kinds of plans in health insurance
If you encounter alphabet soup whenever you shop for plans, the common types are the POS, EPO, PPO and HMO plans. What you choose will help you determine your out-of-pocket costs and which doctors you may visit.
Look for a summary of benefits whenever you compare plans. You’ll also want to check the provider directory because it provides a list of clinics and doctors that participate in the network of your plan. If you want to go through your employer, inquire the summary of the benefits from the workplace benefits administrator.
The Comparison of Health Insurance Plans:
POS, EPO, PPO, and HMO
1) HMO: Health Maintenance Organization
This may minimize the out-of-pocket costs and the primary doctor that takes care of you. It includes working with specialists and ordering tests.
2) PPO: Preferred Provider Organization
This can make in-network care less expensive. However, you might need more provider options without referral requirements.
3) EPO: Exclusive Provider Organization
This can be in use except for any emergency. It can minimize the out-of-pocket costs without the requirement for referrals.
4) POS: Point of Service Plan
This may not be recommended because in-network care can be less expensive. You also need a referral before you can get out of the network. It can be great if you want more options from your provider with a primary doctor that can coordinate the care for you. It includes working with specialists and ordering tests.
Whenever you compare a variety of plans, always check under the microscope the medical needs of your family. Look at the kind of treatment and the amount that you got in the past. It may be impossible to predict all medical expenses but having an awareness of the trends can help you make a well-informed decision.
Whenever you choose a plan that needs referrals like POS and HMO, you need to see a primary care physician before you can schedule a visit or procedure with any specialist. Lots of people prefer other plans due to this requirement.
If it is okay for you to let your primary doctor choose the specialists for you, HMO and POS plans may be better. This system is beneficial because it minimizes your work and your doctor's staff will be the one to handle medical records and coordinate visits.
At Sungate Insurance we work with individuals and businesses throughout the Orlando and Lake Mary area get well protected for medical coverage at prices they can afford. To learn more about how we can help you please contact our agency at (407) 878-7979 or Click Here to request a free quote.