Guide: The Best Health Insurance Plans (How to Find & Get the Best Medical Insurance)
It’s the time of year when people are starting to look for the best health insurance plans. With so many choices for health insurance coverage, it’s hard to wade through all the information.
According to the latest data from the National Center for Health Statistics, 28.4 million people under age 65 are uninsured.
Because the Affordable Care Act of 2010 mandates health insurance coverage, many uninsured people might now be trying to decide which is the best health insurance plan for them.
We will not only show you the best health insurance companies but also how to get health insurance if you’re new to the market.
Whether you’re looking for low cost health insurance or the best health insurance available on the market, there are many factors to consider.
Because each individual and family has differing health care needs, what one person considers the best health insurance policy might be vastly different from another.
Factors to Consider When Shopping for the Best Health Insurance
Before you can figure out how to get health insurance, you need to take a look at your personal situation. You should ask yourself the following questions.
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- How Many People Will Need Health Insurance Coverage?
When looking for the best medical insurance for your family, you must consider whether you will be alone on the policy, or if you’ll have a spouse and children. Sometimes health insurance coverage will cost more if you add a spouse who has the option of signing up for coverage through their own job.
- Do We Have Medical Conditions That Will Require the Best Health Insurance?
Take a look at how often you actually used your health insurance coverage last year and what medical expenses you are anticipating in the future.
The best health insurance for someone who plans to have a baby will be vastly different from someone who only sees the doctor for an annual checkup.
While the number of times you visited the doctor or hospital one year won’t accurately predict how many times you will need to in the coming term, it can show you a pattern of general health and wellness that can help you decide which is the best health insurance plan for you.
Also consider chronic ailments and prescriptions that need to be regularly filled when trying to select the best health insurance plan.
- What Is My Risk Tolerance?
If you and your family are generally healthy, you might be tempted to sign up for lower coverage in order to obtain low cost health insurance. The problem with seeking low cost health insurance over one with higher premiums is that when an emergency arises, the patient is usually responsible to pay a considerably higher deductible before health insurance coverage kicks in.
It’s imperative that you know what you require in a plan before you can decide what the best health insurance is for your situation.
Health Insurance Coverage Basics
If you’re shopping around for the best health insurance plan, chances are you are not covered by your employer. Even if you are covered by your employer, their plan may not be the best deal for you, according to Forbes.com.
There are several options whether you are looking for the best private health insurance or you need low cost health insurance through a state or federal exchange. In order to understand all your choices, you need to familiarize yourself with basic terminology.
HMO: Health Maintenance Organization is a type of insurance plan that generally doesn’t cover out-of-network care unless you have an emergency. Instead, they limit coverage to doctors and providers who are contracted with them.
PPO: Preferred Provider Organization is a type of health plan that creates a network of providers. The customer pays less if they use one of the network doctors or hospitals, or they can pay more to use a provider that is outside-of-network.
POS: Point of Service plans are a mix between PPO and HMO type plans, according to WebMD. You have more choice in who to see but will still have to pay more for using out-of-network providers.
HDHP: A High Deductible Health Plan allows the user to pay a lower monthly premium but carries a higher deductible than other plans.
HSA: A Health Savings Account is type of account that’s used in conjunction with a high deductible health insurance plan. It allows the customer to set aside pre-tax money in order to pay for certain medical expenses.
HRA: A Health Reimbursement Account is an account funded by employers and reimburses employees for qualified medical expenses.
There is an acronym for just about every term used when discussing the best medical insurance to buy. Once you familiarize yourself with the terminology by browsing a site like HealthCare.gov, navigating your options will be much easier.
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How to Get Health Insurance
Once you have assessed your personal health care needs, it’s time to look at what will provide the best health insurance for your situation. There are many factors that play into choosing which is the best health insurance policy for your family.
If you’re eligible for a subsidy through the state or federal exchanges offered by the Affordable Care Act marketplace, it makes sense to look at those plans first at HealthCare.gov.
You can also go through private brokers in your local area to find the best individual health insurance or the best health insurance for your entire family.
How to Choose the Best Health Insurance Plan
In order to choose the best health insurance for you and your family, you need to consider several factors.
Type of Plan
This is where you decide between an HMO, a PPO, or a POS. There are even lesser known plans such as EPOs (Exclusive Provider Organizations) to choose from. Situations that might influence your decision include:
- Whether you want to pick your doctor or you can live with the network choices
- Who is considered a provider in your area
- If you want more choices and can live with higher costs
As you consider each type of plan, look at all of the doctors that are in the network. Buying the best private health insurance includes having access to the medical professionals that you trust.
The best health insurance companies have links to provider directories so you can see who is considered in-network before you purchase health insurance coverage. The same is true for plans sold through Healthcare.gov.
In addition to looking at which doctors are in-network, think about additional medical services such as:
- Imaging centers
Remember, if a medical provider is not in-network, you will likely pay a higher cost.
What the Plan Covers
Due to the Affordable Care Act, all health insurance coverage includes many basic preventative screenings for both adults and kids without the consumer having to pay a copay or coinsurance to meet their deductible, according to HHS.gov.
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Aside from mandated coverage, check what each plan covers while considering your own health status. Consider factors such as:
- How often you need emergency care
- Planned surgeries
- Maternity coverage
- Chronic illnesses
- Prescription medication
Because medical needs vary so greatly, there is not a best health insurance policy that will meet everyone’s needs.
Consider the Costs
Even with low cost health insurance, consumers are responsible for a portion of costs including the deductible, copayments, and coinsurance. Also, the consumer pays a monthly premium.
- Deductible: the amount the consumer pays before the health insurance coverage begins to pick up costs.
- Copayment: the amount the consumer pays for a service. For example, a routine visit to the doctor’s office may have a copayment of $20, assuming the deductible has been met.
- Coinsurance: the amount the consumer pays, as a percentageof the total bill. For example, if the coinsurance is 20%, the cost of a $1,000 medical bill is $200 to the patient, unless the deductible has not yet met met, in which case the consumer is responsible for the entire bill.
- Premium: the amount paid by a consumer to the health insurance company each month to keep the policy in force.
If low monthly premiums are important to you, chances are you will have a higher deductible, copayment, and coinsurance. Remember that the best health insurance isn’t necessarily the one that costs the least month to month. The best health insurance is the one that will cost your family the least amount out-of-pocket overall.
The best private health insurance for a consumer without additional people on the policy might be a low premium/high-deductible plan, assuming the policy holder is generally in good health.
However, if you are looking for the best medical insurance for an entire family that includes children — who may or may not be accident prone — you might be better off paying a higher monthly premium so that your deductible is more easily met and the cost per medical event is lower.
The bottom line when considering cost as you shop for the best health insurance plan is that you need to decide whether you want more coverage with higher premiums or lower premiums and higher out-of-pocket expenses.
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Choosing the Best Health Insurance Policy
Even after taking your personal medical issues into consideration and looking at plans and costs, you still might have a hard time choosing the best health insurance policy. After all, you will likely still have many options on the table.
You will need a policy that:
- Covers the medical needs of each family member
- Allows you to seek care from your preferred doctors and hospitals
- Balances your need for coverage with a cost you can afford
You also need to consider whether or not a particular policy allows you to fund and use an HSA, in which you use pre-tax dollars to cover qualified medical expenses.
At this point, it’s time to look at the best health insurance companies. Whether you’re looking for the best individual health insurance or need a policy that covers the whole family, it’s important to know who you can trust.
According to Consumer Affairs, the top 10 companies that provide the best health insurance are:
- WellCare Health Plans
- American Republic Insurance Company
- Homeland Health Care
- Blue Cross of Florida
- Employee Benefit Management Services
- Kaiser Permanente
- Cigna Tel-Drug Insurance
- Medco Health Solutions
- Blue Cross of New Jersey
While even the best health insurance policies will not be available in every state, the list gives you a starting point.
Top Ten Reviews offers a selection of the best health insurance companies that is more broadly available.
Whether you are seeking the best individual health insurance or you need the best health insurance for your family, it pays to do your research ahead of time. Look beyond the plan premiums and dig into the details. Explore each company’s website, and if necessary seek advice from a health insurance professional. A professional can help you select the best health insurance plan for you.
The best health insurance policy is the one you don’t have to think about after you sign up because you know that the medical needs of your family will be met.
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