How to Compare Health Insurance Plans?

When looking for the right health insurance plan, you need to understand and compare each of these policy components, and then choose a policy that provides the right health coverage at a reasonable cost. This includes looking at the different metallic levels (catastrophic, bronze, silver, gold, and platinum) and comparing each provider's network (PPO, EPO, HMO, and POS).

A premium is the price of your health insurance and what you will pay to continue to cover it. Marketplace plan premiums are a monthly payment paid by your health insurance company. When comparing health insurance plans, evaluate the premiums and calculate, based on your income, the financially reasonable policies.

A deduction represents the amount of money you must spend before your health insurance company provides you with coinsurance or copayment benefits. When viewing the plan discounts, you will see an individual discount, then a family discount, usually twice the individual amount. Every time you use your health insurance and pay for a medical service, these expenses will count toward your deductible. Then once it is reached, the health insurance company will pay for a portion of the medical expenses you incur.

The out-of-pocket limit is closely related to the health insurance policy deduction. It works in a similar way in the sense that if you spend your own money on medical expenses, you will continue to work out of pocket. Between the deductible maximum and the out-of-pocket maximum, you will be eligible for both coinsurance sharing and coinsurance. But once you reach your out-of-pocket limit, all medical expenses you incur will be fully covered by your health insurance company.

Both the out-of-pocket maximum and the deductible are essential to consider when evaluating the affordability of policies. Since you are responsible for all expenses before deduction, if you choose a very high deductible and have high medical expenses, you may not be able to cover the cost of treatment. You should try to forecast your medical expenses for the next year and choose a plan that gives you the most benefits possible, while still being low enough that you can afford to pay toward the discounted amount.

Read more: Private Health Insurance and Short-Term Plans.

How to Compare Metallic Health Insurance Coats

In most state health insurance exchanges, there are five different metal tiers available for purchase: catastrophic, bronze, silver, gold, and platinum. Choosing the right health insurance plan will require you to determine which layer of metal is best for your current health and financial condition.

Bronze and catastrophic health plans have the lowest insurance premiums, but the highest deductions and maximum out-of-pocket deductions. For this reason, the Bronze and Catastrophic plans are affordable for people who are otherwise healthy and do not expect to incur large medical expenses during the year.

Silver Metal level plans are intermediate policy with modest premiums and discounts. These plans are best suited for individuals or families with health insurance needs and average household income. The federal government also allows silver health insurance policyholders to receive cost-sharing reductions if their family income falls below 250% of the federal poverty level. This feature will allow you to pay less in coinsurance, co-costs and deductions.

The Gold and Platinum health insurance plans have the most expensive but lowest discounts available in the federal market. When comparing these health insurance policies to other tiers, you should consider your family's health insurance needs for the next plan period. If you expect a large number of medical expenses, such as drugs or surgeries, choosing a gold or platinum plan at a low discount can be a cost-effective and cheaper option, despite the higher premiums.

How to Compare Health Insurance Networks

One of the main aspects of health insurance that you should consider when comparing plans is the type of provider network each offers.

Each health policy will fall into one of four different types of networks: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), or Point of Service Plan (POS). The main factors to consider when comparing networks are whether the insurance company needs a primary care physician (PCP) for referrals and the level of expenses you incur if you receive coverage outside the network.

A Primary Care Provider (PCP) is a healthcare professional who is your first point of contact for medical care. PCPs will provide you with basic care services and referrals to see other specialist doctors if needed. If you choose a provider network that does not require a primary care provider, you will be able to seek care from professionals yourself rather than obtain referrals.

Private health insurance and short term plans

Private health insurance is very similar to a marketplace plan, except that you can purchase it directly through a health insurance company or broker. Compared to the health plan on the market, private health insurance policies have almost identical premiums and discounts and cover the same number of basic benefits. However, you can't get income-based tax credits if you decide to buy a private insurance policy.

Alternatively, if you are looking for the cheapest health insurance option, you may consider purchasing a short-term health insurance policy. This is poor health insurance that does not include the same benefits as private or individual health insurance. For this reason, you should only consider short-term plans as an option if you lose open enrollment or are between jobs and need health insurance coverage.