Finding the Best Low Cost Ohio Health Insurance
How to find the best, low cost health insurance plan? I can’t tell you how important it is to do your homework, and in this article I’ll try to help you with some of that homework. You might think health insurance is all the same, but the devil is in the details and understanding the details may save you hundreds of dollars.
When you buy health insurance, just as with any insurance, you are paying the company a monthly fee (insurance premium) to manage the risk of your need for health care coverage. The more risk the company assumes, the greater the premium. However, you as a consumer must understand what you are paying for, and you also have to be your own watchdog to some degree and pay attention that you get what you pay for. At its basic level, health insurance is the assumption of risk on the part of the company.
Health insurance comes in many different forms. For example, there is disease insurance, accidental death and dismemberment insurance, catastrophic health coverage, COBRA insurance, and maternity coverage to name just a few examples. All of these, by the way, are kinds of health insurance. When you shop for health insurance you are generally presented with a variety of plans that offer different benefits and different levels of coverage. Insurance plans are the way the insurance is packaged. The plan is the “bottle” holding the wine, as it were.
Some of the kinds of insurance plans most commonly sold are health maintenance organizations (HMOs), preferred provider organizations (PPOs), and private fee for service plans (PFFSs). The HMO, PPO, and PFFS are different ways of packaging benefits. That means that each kind of plan will pay for different kinds of services and each plan will have different payment rates. A payment rate is how much they will pay health care providers for their services. HMOs are usually less expensive but generally require you to get all of your care only from providers in the plan’s pre-determined network of doctors and hospitals. In an HMO you would be assigned a Primary Care physician, and a referral from that doctor would be required in order to see a specialist. Quite often, HMOs work better for individuals who in relatively good health and whose medical needs are not terribly demanding.
The PPO is more flexible than the HMO plan. PPOs may also be a bit more expensive than HMOs, and that is because PPOs are generally thought to give a higher level of coverage. In PPOs, you are not required to have a primary care doctor, and you generally do not need a referral to see a specialist. PPOs have their own network of contracted medical personnel but allow you to go out of the network to see doctors of your own choosing. Now, that costs you more. Before signing up for a PPO, it is important that check with your providers to determine whether they are in the network or will otherwise file claims and accept payment from that particular insurance company. Major insurance companies such as Aetna and Blue Cross Blue shield, Wellmark Blue Cross, and Humana offer PPO plans as well as HMO variants.
Another common sort of managed care plan is the private fee for service plan (PFFS). The PFFS has no pre-established network of doctors and hospitals and leaves your choice of provider up to you. It is important, therefore, that your doctors agree to accept the plan’s payment terms, and that you find out before you receive services if you doctors submit claims to the insurance company. Rather than offering you a fixed package of benefits, as is the case in an HMO or PPO, your providers bill the PFFS a fee for each service you receive, and the PFFS pays for each service according to its fee schedule, or payment rate.
Just what are the real costs of a health insurance policy? The answer to that question will depend in part on the cost of monthly premiums, the deductibles, and the co-pays and co-insurances that you can expect to pay. There is another factor as well that is often ignored, and that is the reliability of the insurance company. If possible, you want to get the best idea you can of the actual reputation of the company for meeting its coverage obligations. In other words, is the company going to pay on the claims per the policy agreement, or will you have to fight every step of the way for your health care. You can see that a plan with a cheap premium could turn out to cost more than a more expensive plan if less expensive plan refuses to pay the medical claims.
It is possible to find cheap quotes for health insurance, but the secret to getting a low cost plan lies in paying only for the key services you need. Basically, then, you want to remove from a policy every benefit you can do without and then assume as high a deductible as possible. And again, you want to undertake the due diligence to establish the company’s reliability. In a time of need, it is vital that the insurer pay in a timely fashion without argument.
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