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Health Insurance Information

Health Insurance

Finding affordable health insurance may seem like a daunting task. With the Affordable Healthcare Act and new regulations taking effect, people are more confused than ever. How do you sort through plans, deductibles, and networks, and choose a policy that makes sense for you, your family or your employees? An Insurance Station agent who specializes in health insurance can be an excellent resource when you want to evaluate health plans.

Healthcare Costs, Co-pays and Coinsurance

Your healthcare costs are an important factor to consider when you want to buy health insurance, and you have a number of options for managing those costs. You can choose to pay a higher deductible to lower your regular premiums, which means you need to pay that deductible amount for doctor’s visits and medical bills before your health insurance kicks in. Alternatively you can pay a higher premium in order to avoid a high out-of-pocket cost in the event of a serious illness.  Co-pays and coinsurance are two methods health insurance companies use to share the cost of healthcare. Co-pays are a small amount you pay for every doctor’s visit, whereas coinsurance is an amount you pay in the event you need additional care. Be sure to fully understand any coinsurance payments your health insurance plan requires. In the event of a serious illness or injury, these costs can become very high.

Health Insurance Coverage Plans

There are a number of different types of health insurance plans for individuals and families:

• PPO or Preferred Provider Organization: This type of plan works similarly to an HMO but has more flexibility. Visiting a doctor within the insurance network means you will pay a smaller percentage of your bill. If you visit a doctor outside of your network, your insurance company will pay less of your bill but some will still be covered. With this plan, you still have affordable coverage but maintain flexibility at a price.

• POS or Point of Service Plan: A POS takes the best of a PPO and an HMO and combines it into one plan. Similar to an HMO, you still have a primary physician who provides referrals within the insurance network, but it is possible to see a specialist on your own accord outside of the network. Instead of co-pay, you may need to pay out of pocket or pay a percentage of your bill for out of network providers.

• HSA or Health Savings Account: An HSA account works like a medical savings account. You combine a high deductible health plan (HDHP) policy with an HSA bank account, both of which help pay for healthcare. Until your deductible is reached on your HDHP, you can use your HSA account to take care of expenses like co-pays and health care costs. Some HSA insurance plans will provide full coverage for preventive care without needing to meet deductible requirements.

• Long-Term Care Insurance: LTC insurance is a type of health coverage that can help you cover your future costs if you ever need assistance or care due to an accident, injury, illness or age-related health issue. For example, long term care insurance can help you pay for an extended need for nursing home care, an assisted living facility, at-home care or rehabilitation and occupational therapy.

• Medicare: Medicare is a federal health insurance program for people age 65 and older, as well as people with disabilities and severe health conditions. It is divided up into four different parts: Part A, Part B, Part C and Part D. Supplement Plans are also available to help cover the costs that Medicare does not cover.

What type of policy is best for you will depend on your current situation. The best policy for you today may not be the best policy for you next year.  It is extremely important to revisit your health care needs with your Insurance Station agent. There may be life events that have happened that we don't know about until you tell us!


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