Selecting the Right Health Insurance Plan

Health insurance is available in different plans, but choosing the right one may seem like a tough decision to make. The fact is, most health plans are similar, but there are options that should be carefully considered to make sure that the policy you buy into will be sufficient to suit the needs of you and your dependents.

There are three primary types of health insurance plan: HMO, PPO, and POS. The HMO is typically the least expensive type, but it can also be the most restrictive. PPO plans give you more freedom within the plan, but you are likely to have additional costs. POS plans are generally the most expensive type of health insurance, placing a greater share of the cost on you, but offering the freedom to choose where to receive your care and when to see a specialist.

Under an HMO, your primary physician is the "gatekeeper" who determines when you need to see a specialist. As your primary caregiver, you would see this physician before going to another doctor, and he would then set you an appointment and write a referral. All care remains inside the HMO's physician network. If you insist on using a physician outside of the network, you may be responsible for the entire cost.

With a PPO, there is no gatekeeper who decides which specialists you need to see, but there is still a network of caregivers you will have to choose from. One advantage of a PPO is that you can still go out of network, but the plan will allow you to go outside the network. The catch is that you are responsible for paying the difference between having the procedure done in network and what your selected care giver charges.

In a POS, you are able to choose your physicians and specialists, set your own appointments and act as your own health care manager. The plan will pay a majority of the costs, but you are required to pay a percentage of each procedure out of pocket. POS plans give you the most freedom, but they have the potential to be very costly over time.

Once you have settled on a plan, look at the benefits and limitations. It does not help you to save money on a health plan that excludes coverage for your preexisting conditions, or that will not provide natal and maternal care. Pay close attention to the copays, coinsurance and associated costs. The point is that insurance will not pay for everything, so find the policy that best meets your particular medical needs.