Finally, you’re at the stage of your life where you have to bear the responsibilities of your family and yourself. These responsibilities increase if you live in a nation like the US, where it’s mandatory to sign-up for specific services, or else there can be legal actions against you. One such standard service that you need is a health insurance plan, but you might be confused about the question, “what is the best health insurance plan for you?”
Before you consult this query, you should know why it is important. Every person in several states is required to have some form of health insurance plan. It gets even more important if someone in your family suffers from an illness because the healthcare costs are too high. Therefore, you might want to search for the best health insurance plan that serves your healthcare needs and is within your budget.
However, as you set out to search for your best health insurance plan, you get overwhelmed with the choice of options. Are you also clueless about a suitable plan for your needs? Don’t worry. Here we’ll give you a complete guide about the types, metrics, and the best health insurance providers.
What Are the Types of Health Plans?
If you are less than 65, you have to resort to the individual and family health plans because the state-provided Medicare is only available for seniors. At this point, you also get the freedom to choose plans according to your budget and preferences. Generally, there are four types of best health insurance plans with varying characteristics and different critiques. Let’s check each of them.
Health Maintenance Organizations (HMOs)
HMOs are popular plans because they have been on the ground for a while now. HMOs, provide you with a local network of healthcare professionals and hospitals. You can only lurk between the specific networks, or else you will pay a hefty healthcare fee if you go to an external provider. Plus, a primary care provider (PCP) is assigned your home base for medical services.
They’ll provide you with all the necessary healthcare services and will give you referrals if you have a condition that needs a specialist’s attention. Since HMOs are restrictive, they usually have low premiums.
Preferred Provider Organizations (PPOs)
They are the complete opposite of HMOs. With an extensive network of service providers and doctors, you can see any provider within your network. The excess coverage allows you to find specialists for different problems. Plus, you don’t need a referral to see an outside specialist. Even if you see one, you’ll bear the cost.
Since PPOs have more perks than HMOs, they have higher premium costs and may even carry deductibles.
Exclusive Provider Organizations (EPOs)
EPOs are similar to HMOs but with added perks. You have access to a slightly more comprehensive network. Plus, you have the autonomy to choose your PCP and may even see a specialist without requiring a referral. However, you can’t get coverage if you see an out-network specialist, except in cases of emergencies.
Point of Service (POS) plans
POS plans are a mix of HMOs and PPOs plans. You have wider network access than HMOs, but it’s less than PPOs. However, you have to choose a PCP for medical services and may even need a referral to see a specialist.
Tiers of Health Plans
Having discussed the basic types of health insurance plans, you might be thinking, what is the best health insurance plan among all? Well, there’s no definition of the “best health insurance plan”; all of them differ and might be the best for you according to your need. All these plans have further tier categories, including bronze, silver, gold, and platinum.
Most insurance providers offer all these tier types. These differ in their premium, benefits, and deductible payments. The following is a brief explanation of each tier:
- Bronze: It’s the cheapest health plan with the lowest premiums. However, you have to pay 40% of the cost, while your provider bears the rest.
- Silver: This type also offers a low premium, but the partnership is 70-30. You pay 30% of the cost of the healthcare, while your insurance provider covers the rest.
- Gold: It’s a premium plan with high premiums, and you only have to pay 20% of the cost.
- Platinum: Platinum is the most esteemed plan with the highest premiums and only 10% co-insurances.
All these plans should offer benefits like hospitalization care, maternity, preventive care, mental health, and prescription drugs. These plans have deductibles, but it varies with the providers. Sometimes, they can be as high as $8000, while some may even allow for a $0 deductible. Plus, the decision of copays and co-insurances varies.
Sometimes you pay a fixed cost for healthcare, i.e., copay, while sometimes, you pay a fixed percentage for every healthcare, i.e., co-insurance. Last but not least, there’s another coverage called the catastrophic plan, which is only for people who are under 30. This plan boasts of low premiums and high annual deductibles, making them perfect for young individuals.
What is the Best Health Insurance Plan for Me?
As mentioned earlier, the best plan is one that meets your criteria of “best.” Suppose you’re a young, energetic individual who takes care of your health. Would you need platinum insurance that covers most healthcare needs? No, because you’ll be better off with a low premium plan to meet the state requirement.
So, when you’re contemplating the question of how to pick the best health insurance plans, consider your needs. If you’re in good health and you get sick less often, a low-cost HMO plan will be perfect for you. In contrast, if you have a healthcare problem or diseases like diabetes, heart problem, or asthma, you should have a healthcare plan to help you cover the cost of frequent doctor visits.
Similarly, if you have a chronic illness like cancer or liver failure, you will likely incur high healthcare costs. Frequent doctor’s visits plus the cost of prescription drugs and other services can take a toll on your financial health. Therefore, resorting to a PPO gold/platinum plan can be the best option because you get wide access to services and low out-of-pocket costs.
Nonetheless, the quest to find the best health insurance plan for you differs from needs and lifestyle. What works for you won’t be suitable for someone else.
Which Health Insurance Company Is the Best?
In the USA, numerous private companies are striving to help affected people live easy life. Some of the most popular and best health insurance companies with accreditations and awards are as follows:
United Health Group
This company tops the list because it provides nationwide insurance coverage and has a high pool of offerings. The company serves around 46 million Americans and another 7.6 million people globally. It has the AM best A grade award and a high ASCI ranking which sets it apart from the rest.
The company provides travel health, group, individual, Medicare, and dental coverage from a huge list of offerings.
While this company doesn’t have nationwide coverage, it’s popular due to its esteemed customer service and a pool of amazing plans. You have the option to go for health-saving plans, private services, or multiple offerings from different tier health insurance plans.
This is another best health insurance company that provides nationwide coverage and many plan options. It has good ASCI and AM best ratings, and BlueCross is popular for its HMO, PPOs, and FSA health-saving plans. With health saving plans, you can make money tax-free for deductibles and other health expenses.
Aetna is a popular company with huge offerings specifically for Medicare and Medicaid options. Unfortunately, Aetna doesn’t offer individual plans, but other groups and international insurance companies explain the high credentials awards, including AM Best A rating and ACSI rank of 71.
Another huge company that covers the entire nation and provides offerings that cover even the slightest care option. Cigna insures around 17 million people globally through its individual and family health insurance, Medicare, dental, under-65 options, group health plan, and international coverage.
You’ll need a health insurance plan to combat a health complication in your life at any instance in life. So, why not sign-up for a health insurance plan and save yourself from all the financial, mental, and emotional trouble. Solving the mystery of what is the best health insurance plan is best answered by the companies mentioned above.
They have a single aim to provide you with easily accessible and the best insurance plans. Since they come in all ranges of affordability and offerings, you can benefit from them as per your preferences. If you haven’t now subscribed to any health package, it’s time to take action and take hold of your life.
Insurance Shopping is the one-stop solution that can find you healthcare plans that serve you the most. Visit our website and explore our range of options to get free quotes.