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How to Choose the Right Health Insurance Plan

How do I choose the right insurance plan?

Here’s a checklist on how to get started on choosing the right insurance plan:

Go to your marketplace and view your plan options side by side.

Are you getting covered through your employer?  Will you have to purchase a plan through the health insurance marketplace during open enrollment?  New Jersey’s timeline for open enrollment is November 1st-December 15th, 2018.

Decide which type of plan — HMO, PPO, EPO, or POS — is best for you and your family.

HMO Health Insurance Plans

HMO plans are known to give access to certain doctors and hospitals within their network.  The network is made up of providers that agree to lower their rates for members of their plan and they also meet quality standards. What makes an HMO plan very different than a PPO plan is that care is only covered if you see a provider within the HMO network.

HMO plans are very restrictive. When you purchase an HMO plan, you are asked to pick a primary care physician that is in your network. All of the care you receive is coordinated by your primary care provider. This means if you want to see a specialist, you will need a referral from your primary care provider. 

HMO’s have cheaper premiums and do not cover out-of-network health care services. 

PPO Health Insurance Plans

PPO plans are pretty flexible. They do allow you to choose an in-network doctor at a lower cost or an out-of-network doctor at a higher cost. 
You do not need a referral from your PCP to see a specialist. PPO plans often come with higher premiums. 

Eliminate plans that exclude your doctor or any local doctors in the provider network.

Determine whether you want more health coverage and higher premiums, or lower premiums and higher-out-of-pocket costs.

Make sure any plan you choose will pay for your regular and necessary care, like prescriptions and specialists.

New Jersey’s open enrollment is around the corner.  Make sure you plan now and contact Cosmo Insurance to help you through the process.