With rising healthcare costs, health insurance is a necessity nowadays. In fact, some companies use health plans as an incentive to attract and retain employees. But what if you’re a business owner? What if your employer doesn’t offer health benefits? Do you know what to do? Where to go? How to do it? Here’s a step-by-step guide to choosing the best plan.
If your employer doesn’t offer health benefits, you may shop at your state’s marketplace or the federal marketplace to find the lowest premiums.
You may also purchase directly from the insurer or through a private exchange. Note, however, that you won’t be qualified for subsidies.
Compare various health plans.
While shopping for health insurance, you’ll encounter the following types of plan.
HMO (Health Maintenance Organization). HMOs have their network of providers. Thus, to get covered, you need to stay within that network except for emergencies. Should you need procedures and specialists outside the network, a referral is needed. HMO is the best option for you if you are looking for lower out-of-pocket expenses and a primary physician that will coordinate your care for you.
PPO (Preferred Provider Organization). PPOs won’t require you to get treated by in-network providers. And while you have the freedom to choose doctors and hospitals, doing so may cost you. Choosing in-network providers is still less expensive. And because PPOs give you the freedom to choose, you won’t be needing referrals for procedures or to see specialists.
POS (Point of Service Plan). Although POS plans also give you the freedom to go out of network for treatments, you will still need a referral. And again, in-network care is less expensive with POS.
EPO (Exclusive Provider Organization). Like HMOs, EPOs needs you to stay in-network except for emergencies. However, you don’t need referrals for seeking care from specialists or for certain procedures.
Compare network of providers.
If you have preferred providers and you want to keep seeing them, ensure that they are within the network of the plan you’re choosing. You can ask your physicians directly if they are under a particular plan.
If you don’t have a preferred provider, on the other hand, you might want a plan that will give you more choices. A larger network is vital when you are living in rural areas so you’ll more likely find a local doctor under your plan.
Compare out-of-pocket expenses.
The plan’s summary of benefits should clearly state how much out-of-pocket expenses will be. Note that cost-sharing options vary, so narrow down your choices based on out-of-pocket costs.
Check the summary of benefits to see which has a wider scope of coverage. Some may have better coverage for certain things, while others have better coverage for particular services. Choose a plan that is best for your current health situation.
If you still have more questions lingering, you might want to talk to the experts. Roper Insurance Services strive to provide health insurance according to your needs. We represent reliable companies that will give you the best coverages with the lowest rates. Get a free quote from us now! Call us at (828) 388-1851 or visit us today.