Learn Something!
Health insurance isn’t as frustrating when you’re informed and have your priorities straight. My goal is to provide necessary health insurance knowledge in order to ease the process of searching for coverage.
I’ve started to send out newsletters to my clients, and I figured I'd share this information here for others to view as well!
Feel free to share with anyone that you think may benefit.
As always, don't hesitate to reach out to me with absolutely anything regarding health insurance!
COMMON HEALTH INSURANCE TERMINOLOGY:
Premium: Your monthly payment towards your health insurance.
Deductible: The dollar amount that the insurance company wants you to spend out of pocket before they start to give you all of your plan’s benefits.
Maximum out of Pocket: This is the absolute most you’d have to spend toward services/claims in a calendar year out of pocket. This contains your deductible and then any copayments or coinsurance afterwards up to whatever maximum is listed with your plan. Typically it's between $7,000-$9,000.
**This is one of the main differences between short term coverage and full comprehensive coverage. Short term plans don't have a true maximum out of pocket, so you could potentially be left financially exposed during a major claim**
PPO vs. HMO vs. EPO Networks: HMO and EPO networks are smaller, and more restricted to doctors/clinics in your zip code and surrounding area. PPO networks are nationwide, meaning you can take your coverage state to state and not worry about any lapses.
Copayment: A dollar amount that the insurance company associates to a service. For example, a plan can have a $60 copayment towards a primary care visit rather than you paying full price for it.
Coinsurance: This is the insurance company agreeing to pay a percentage, while you’re responsible for the remaining portion. A very common example is 80/20 coinsurance, where they would pay 80% of bills incurred and you would be responsible for 20% up to your maximum out of pocket.
Are there any other terms that you see frequently and would like a further explanation? Feel free to ask me, I’m happy to explain!
Avoid getting denied coverage through your health inusrance by understanding PPO vs. EPO/HMO networks! #healthinsurance #PPO #healthadvisor #travel #selfemployed
Short term insurance is meant for exactly what it sounds like - short time periods. Even then, if you can afford full coverage during that period I highly recommend sticking with that!
Be sure you know what your priorities are before searching for insurance. This can help an advisor narrow down options for you
Try to contact a licensed advisor about health insurance rather than going online to search for quotes yourself. This will save you from a lot of bombardment by telemarketers!
You're not locked into expensive or low quality employer plans.
Understand these 3 terms fully before you start your search for health insurance.
A deductible is the dollar amount that you have to come out of pocket before 100% of your plans benefits kick in.
Max out of pockets are the backbone to maintaining financial stability when it comes to major medical claims.
There are 3 types of networks. EPOs you do not need a referral to see a specialist, they're similar to HMOs in the fact that they're coverage in your county/surrounding counties.
If you're not offered employer insurance, there are going to be 2 ways to obtain affordable full coverage.