I want to buy Health Insurance for me, my wife and my kid. I live in Minnesota. I can spend about $500-$600 monthly for Insurance. What all I should look for? It is so confusing. PPO, Deductibles, Coinsurance, and all these plans... I know only a little, and it is very hard making a choice. Please Help!
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I work for a health insurance company and I will tell you where insurance companies make their money...when you don't use your insurance. I'm not sure what the cost of the plans you looked at are (or why that other person said not to go with a HMO) but if you and your family are overall healthy then an HMO is probably your best and cheapest way to go. HMO means that you will have a primary care doctor or general practioner who will have to refer you to another doctor for "specialty" issues they can't/don't deal with. Example a cardiologist or dermatologist. You would go to your primary doctor for sick and routine physicals. The only downfall to this type of plan is that they are your PRIMARY CARE doctor and can chose who they will refer you to; most doctors will give you a few choices and may even take your suggestions if there is a doctor you would like to see but this all depends on the doctor. Some doctors are part of "groups" and will only refer you to someone in their group and this is generally something the doctor has agreed upon when joining that particular group. So your best bet is to ask if you have a doctor in mind of who you'd like to select. These plans you will usually pay a copay (say $15/$20 for office visits) and thats it but alot of companies are now offering plans that come at a cheaper cost to you but you pay a deductible or have coinsurance for certain services say lab work or x-rays as an example. If your family don't frequent doctor's offices or emergency rooms I think this it the best bet. (its what I have) With a PPO plan you don't need referrals to specialists and usually has 2 levels of benefits. In network and Out of network. In means you are seeing a doctor that is a PPO provider out of network you can see anyone who is not a PPO provider but at a higher cost; usually a deductible and coinsurance. These plans however usually cost more than an HMO plan. Important things to know... Deductible- you are responsible for paying this amount before your insurance will pay for anything. (usually more for a family, example $1000 per family member or $2000 family maximum so you would not have to pay more than $2000/no matter if there are two people on your plan or four; this is per calendar year so it would start again the following year). Some company offer high deductibles which you may want to be leary of because it will be like not having insurance at all! Coinsurance- cost sharing with the insurance company (80/20, 70/30) it all depends on the plan you chose but they will pay the higher amount. Copay- how much you pay per office visit (whether it be mental health or a regular office visit) Some plans contain a combination of the three...just look at the plans and ask for a breakdown of anything you're not sure about. They should be happy to explain any questions you have about what you're paying for. Feel free to email me if you have any other questions.
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