Health insurance is as important as plants that protect your life, car, or home. Unfortunately, 10% of U.S. adults don’t have a program. The situation is unnecessary since there are available marketplaces to purchase insurance. To help you through the process, here are tips on enrolling in a medical plan on your own.
Search for Marketplaces
The health insurance sector has changed since the approval of the Affordable Care Act (ACA). You don’t need to purchase your medical plans directly from an insurer. Today, states and the federal government offer insurance marketplaces.
There are several advantages to this exchange. First, you can compare companies to find the best coverage, deductibles, and premiums. Second, the marketplace’s medical plans cost far less. Thus, you can obtain a health insurance policy with little or no upfront payments.
Compare Plans
Never select the first medical plan you see. You don’t know enough about it to make a logical choice. Furthermore, you’ll be surprised by the lack of coverage or high deductibles. In other words, you must compare available plans.
It’s easy to do this on an insurance marketplace. If you go it alone, you need to compare a minimum of three plans for a good idea of options and deductibles.
Know What Each Plan Requires
Each medical plan offers different capabilities. So, get an idea of their benefits to performing a proper comparison.
An HMO (Health Maintenance Organization) has the most limitations. You can only select hospitals, doctors, and specialists from a list of approved providers. Further, a general practitioner (GP)must complete a referral to see a specialist. On top of these items, an HMO only covers out-of-network visits in emergencies.
A PPO (Preferred Provider Organization) features broader coverage. The list of approved providers is much deeper, and referrals aren’t required to see a specialist. Plus, you have the option to see a GP or specialist outside of the PPO’s network. However, you pay more in deductibles.
An EPO (Executive Provider Organization) is an HMO+ plan. There’s more freedom to choose your health care providers, and you don’t need a referral for specialists. Yet, out-of-network providers still aren’t covered unless it’s an emergency.
A POS (Point-of-Service) plan is between an HMO and PPO. You have a broader range of in-network providers and can use outside GPs and specialists with the proper paperwork. A referral isn’t needed; however, the doctor coordinating your care must refer you.
A catastrophic medical plan has a low premium but deductibles as high as $8000. You must pay out-of-pocket for certain services until you reach the limit. The insurance covers 100% of the costs once done.
Fortunately, a catastrophic plan offers three primary care visits outside the deductible. Additionally, preventive care is covered even when you don’t meet the deductible.
Know the Difference Between Medicaid and Medicare
Another factor to consider when you enroll for a medical plan is the difference between the federal government’s plans — Medicaid and Medicare. The former is for low-income families and children. Enrollment for Medicaid is through state-based organizations. Approval is by your family’s size and economic status.
Medicare is for those who are 65 years or older. Enrollment is automatic if you collect social security or are eligible for the federal program. You receive Part A (hospitalization) and Part B (medical) insurance at registration.
However, Medicare is more than the above coverage. Other parts help close gaps when it comes to prescriptions and advanced care. Enrollment for these supplemental programs is through other organizations.
For instance, you would apply for Medicare supplement plans in Nebraska through the state or approved companies like Omaha Insurance Solutions. Generally, they handle paperwork completion and then submit the materials for approval. It prevents you from repeatedly sending applications because you don’t include important information.
Consider a Health Savings Account to Cover Out-of-Pocket Costs
After you enroll in a medical plan, consider how you’ll cover out-of-pocket costs. A solution is to set up a Health Savings Account (HSA). Money automatically goes into this fund from another bank account or your paycheck. An HSA is an easy way to minimize your overall health costs.
Take this information with you when you enroll for a medical plan on your own. It should help you get a handle on your needs.
