Description: The following passage mainly focuses on esurance login, which will show you how to compare and select health insurance plan. There are four categories of health insurance plans, bronze, silver, gold and platinum. The information is provided by a licensed insurance agent.
Welcome back to my channel, let’s talk about money, today I will be addressing a very important question, that is how to compare and select health insurance plan, this is the most common question I get as an insurance agent, it’s my job to help you.
In this article I will share all you need to know in order to make an educated decision while shopping for health insurance plans, I will also give valuable tips, you can also refer to other articles that I recently posted, for example in one of the articles I explained the difference of PPO, HMO and POS plans, by knowing these things you will be able to navigate and compare plans with confidence.
I will give away free tips and tricks that will help you choose a health plan and save money, let’s start with the basics, there are four categories of health insurance plans, bronze, silver, gold and platinum, these categories show how you and your plan share the cost.
Plan categories have nothing to do with the quality of care, there is also a catastrophic plan for those that qualify, it’s usually for those who are under the age of 30, each level pays a different portion of your healthcare bills, this way grouping plans makes it easier to shop for insurance.
For example the top-of-the-line plan is platinum, it pays the highest portion of your healthcare bill, it also cost the most, the basic plan is bronze, it pays an average of 60% of your healthcare bills and costs the least, let’s start with the catastrophic plans.
This is a minimum coverage plan for those who qualify, if you are under age of 30, you may be able to buy an additional health insurance plan option called minimum coverage plan, these plans usually have lower premiums and mostly protect you from worst-case scenarios.
There is one very important thing that many consumers do not know and end up overpaying for their health insurance, those who have minimum coverage plans do not qualify to receive premium assistance also known as advanced premium tax credits.
Minimum coverage plans usually cover three doctor visits of urgent care visits with no out-of-pocket costs and pre preventative benefits, all other services will be full price but at the negotiated in-network price until you reach the out-of-pocket maximum.
Here are a few reasons why you might consider this type of plan, let’s talk about bronze plans, these are usually the high deductible plans, on average your health plan pays 60% of your medical expenses, you pay 40%, I will go over the details for these plans shortly.
Silver plans are the most popular ones on the market so far, on average your health plan pays 70% of your medical expenses, you pay 30%, in some cases individuals may qualify for an enhanced silver plan, this means that when they choose a silver plan, they have based on their income enhanced out-of-pocket savings to lower co-pays, coinsurance and deductibles.
Individuals in the savings categories get the benefits of a gold or platinum plan for the price of a silver plan, these plans are only available on the exchanges, feel free to reach me and I’ll help you understand if you qualify for enhanced silver plans.
Let’s look at the gold plan, gold plans on average of a health plan pay eighty percent of your medical expenses and you pay twenty percent, this plan does not have a deductible, let’s move on to the platinum plan, on average your health plan pays ninety percent of your medical expenses, you pay ten percent, this plan does not have a deductible.
Let’s take a look at a comparison of health plans for year 2018, at the Medical categories and coverage for year 2018, there are a few things to remember, benefits shown in blue are not subject to any deductible, white corner is subject to a deductible after the first three visits.
Copay is for any combination of services which includes primary care and specialist Urgent Care for the first three visits as well, after three visits they will be at full cost until the medical deductible is met, let’s take a closer look, as I said for bronze plans you don’t pay the deductible for the first three visits.
The lamp is $40 copay and is not subject to deductible, the annual wellness exam which is preventive is included extra cost, the copay for the primary care visit in Urgent Care is $75, specialist’s visit is 105 dollars, this might be a good plan for those that are healthy and rarely go to the doctor.
Obviously if you need more care, you will have to pay more out-of-pocket money, the maximum out-of-pocket you pay is seven thousand for one individual or fourteen thousand for the family, let’s look at the silver plan, the silver plan has a lower deductible.
There are no restrictions on how many times you can visit the doctor, the area that is highlighted in light blue is not subject to deductible, you will pay deductible mostly when you are hospitalized, I will add the detailed summary of benefits for the full description once it is available.
The gold plan has no deductible, the co-pays and coinsurance are lower than those for the silver plan, this plan costs more each month, but the insurance pays on average 80% of your medical cost, you pay the rest which is 20%, the platinum plan has no deductible, the co-pays and coinsurance are lower than those for the gold plan, this plan costs more each month, but the insurance pays on average 90% of your medical cost, you pay the rest.
Obviously the platinum plan has the highest premium each month, if you are healthy and readily go to the doctor, it might not be a good idea to buy the most expensive plan on the market, I’ll share some secrets with you about selecting a health plan that will fit your needs and save you money at the same time.
How do you decide which plan is right for you? Start by thinking about your past and future medical bills, for example let’s say you’re healthy most of the time and don’t expect to meet costly medical services during the year, then a bronze plan that has the lower price tag and pays for a lower portion of your eligible medical bills may be a good choice for you.
On the other hand, let’s say you know you have a medical condition that will need care or you have an active family with children who play sports, a gold or platinum plan that pays for more your medical costs may be a better fit for you.
It is also very important to look at the summary of benefits for any plan you are seriously considering, this document tells you what medical services the plan pays for and perhaps most importantly what it does not pay for, make sure that you like the plan type.
For example a health maintenance organization or an HMO will require you to have a primary care doctor and get referrals for any specialist you want to see, a preferred provider organization or a PPO will give you more leeway in choosing doctors.
Check the plans provider network directory to make sure your that primary care doctor is listed, if you want to keep that doctor, you can also call your doctor’s office and ask whether they accept the specific plan you are considering, check the plans drug formulary which is the list of covered drugs to make sure that any prescription medications you take are included.
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