While getting an affordable healthcare gets to be complicated, there are still ways that can reduce costs you spend on your health.
Below, we discuss the algorithm on how to save on your individual healthcare plan.
Examine Carefully Your Options at Work
If you are currently employed with any entity, it is worth it to look into health insurance benefits offered at your company.
Health insurance benefits offered by your employer:
It is the most common type of a subscription in the United States. An employer-paid group plan might have limited options, however, your company also shares the total cost of a premium with you. Besides, your premiums can be pretaxed alongside with contributions from an employer. That will result in significant tax savings for you. Last but not least, an employer will choose the health insurance provider and the specific plan options.
If you are not employed with any company, or self-employed, it is highly recommended to consult a health insurance professional, who can figure out a plan that would work best for your budget.
Benefits of individual plans:
- You can pick the insurance company and plan that is best for you.
- You can change an employer without losing your initially chosen insurance coverage.
- You can pick a plan that targets specific medical specialists who you think are most relevant to you.
2 Learn How Different Insurance Plans Operate
There are three major types of health insurance plans. The understanding how these work may help you save your insurance costs dramatically. We are breaking down the three types of plans below:
1 Health Insurance Networks
Each of these networks utilizes a specific set of healthcare providers. These providers, in their turn, have an agreement to reduce cost of their respective service in exchange of benefits that belonging to the network gives them.
- Health maintenance organizations (HMOs)
These give access to physicians, clinics, as well as hospitals. To be eligible for this type of plan, you usually have to live in the area the network operates in.
- Preferred provider organizations (PPOs)
With this insurance plan from PPOs, you would spend less when you choose from a network of organizations that belong there.
- Point-of-service (POS)
With this type of plan, you have to pick a specific primary care physician, who, in his turn, will refer you further to medical specialists for care. You can choose a care from doctors out of your network, but on your own expenses.
- Exclusive provider organizations (EPOs)
If you have this kind of plan, healthcare services are covered only when you use providers in your network, while emergency cases are an exception to the rule. You can learn more about it at Canadian Health and Care Mall, a site that comprises elaborately compiled information on the subject
2 Health Insurance Tiered Plans
There are health insurance plans that are governed by tiers, while each tier affects costs you would pay out-of-pocket as opposed to what a health insurance covers. Insurance plans with lower out-of-pocket costs tend to have much higher monthly premiums, and vice versa.
3 High Deductible Health Plan (HDHP)
This is the type of plan that ensues higher deductibles, compared to regular health insurance plans. An insurance plan with a deductible of $1,300 for an individual qualifies as a High Deductible Health Plan.
This type of plan offers lower monthly premiums. On the other hand, an individual will have a higher deductible and healthcare services like vision, dental, getting prescription drugs, and some others are usually not covered at all, or covered partly.
The Advantages of a Health Savings Account (HSA)
There are saving accounts that have an option of saving money spent for healthcare costs, making it tax-free.
The advantages of using a health services account include:
- Tax-free contributions;
- Lower monthly premiums;
- Savings roll over year-to-year;
- The option of investing your money with lucrative interest rates.
Make Sure to Stay In Network
Regardless how your choices would turn out, there is the sure strategy to save your healthcare spending if you use medical specialists and hospitals that belong to your health care plan’s network. Usually healthcare providers that belong to the network have a mutual agreement in order to lower fees on services while in exchange having access to benefits for the plan’s network members.
It is important to recognize two major ways your costs would be calculated depending on your relationship with your network insurance provider:
- If you have an HMO or EPO plan, you are usually responsible for the entire cost that you get from an out-of-network provider.
- If you, on the other hand, have a PPO or POS plan, your insurance may partly cover your costs. But since your costs have not been discounted, the amount you would eventually owe will turn out to be higher.
The catch is that a subscriber bears the responsibility of checking if your provider belongs to the network and how the providers operate within the network regarding the distribution of costs. Just because a hospital accepts your insurance does not necessarily entail they are an in-network entity.
On the other hand, when you receive services from an out-of-network provider, they can charge full price for anything that your insurance provider doesn’t cover.
Checklist for Choosing a Beneficial Healthcare Insurance Plan
- Visit your local marketplace (see full list) and compare plan options side by side.
- Decide which type of plan out of HMO, PPO, EPO, or POS works best for you.
- Try to avoid plans that do not include your doctor in the insurance provider’s network.
- Figure out if you want more health coverage and higher premiums, or, vice versa, lower premiums accompanied by higher out-of-pocket costs.
- Consult a healthcare insurance plan provider and make sure a plan you are looking at includes regular and necessary care, including prescriptions and specialists you are really in need for.
On top of everything written above, there are ways to help you receive medication for less in the absence of whichever insurance plan.
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