I have spoken to a lot of people who were not satisfied with their health insurance plans. Most of the time, they really had not taken the time to understand their purchases before they needed to seek medical care, and so, they were not happy with the coverage that was clearly spelled out in the policy. I, myself, have had a similar experience because I did not realize that the doctor's visit copay did not cover any blood tests that were performed. Sometimes a doctor's copay does cover these tests, and sometimes it does not. Do you know how your current health insurance covers various medical services that you seek?
It will take some time, but it is important for you to become educated about various health insurance plans before you sign up. After all, you know that premiums are a big part of your monthly budget, and you know that your health care is very important. I find people spending more time researching a computer or tv purchase than they spend on learning about health plan choices!
Look at the most common type of major medical insurance on the market today, and also our tips about who is likely to be satisfied with the various plans.
PPO: A preferred provider organization (PPO) plan includes a network of medical providers including doctors and hospitals. The plan will provide the highest coverage if an insured person seeks medical services inside this network, but will still cover other providers. This plan usually strikes a balance between having the insurance company manage costs and allowing some flexibility. PPO plans are probably the most common major medical plans chosen these days because that balance.
HMO: A health maintenance organization also contains a network of medical providers, and is very strict about only covering services inside this network. HMO insurers strive to have the most control over costs. However, many insured people who have access to a large HMO network are very satisfied with their care.
Note that both HMO and PPO plans will make exceptions to their network coverage rules in the case of emergencies. Sometimes, if a certain type of medical provider has not been included in the network, the company will also make an exception. In that case, though, it is always best to have the medical service approved in advance so it cannot be disputed later.
HSA: Health savings account plans are actually medical plans that come in 2 parts. A tax advantaged savings account that can actually earn interest is one part. This account can be used for a variety of medical expenses, and sometimes the accounts even come with a debit card! Any money left in the plan at the end of one year will roll over to the next year so no money is risked. And the money can be used for many medical services that are not even covered under most major medical plans, including dental care and vision care.
The second part of an HSA is a high deductible major medical plan, and sometimes this plan is actually a PPO. Because of the high deductible, premiums should be affordable, leaving some money in the budget to contribute the the savings account.
HSA plans tend to work well for disciplined savers who want control over how their health care dollars are spent. PPO plans provide some flexibility with predictable costs. HMO plans provide predictable costs, do not require the consumer to manage their own health care costs, but are the least flexible. I know people who have chosen one of these plans, and were very satisfied, so the choice of the best type of health plan for you comes down to your own needs, budget, and the way you want your medical services managed.
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