Selecting a health insurance plan is like searching for the right pair of jeans. It can be time consuming and you may have to look at several, but it’s worth it to find the right fit. Show
Let’s review the following plans and how they might be the best match for you:
Health Maintenance Organization (HMO)With this plan, you choose a primary care provider (PCP) who coordinates your care using doctors and hospitals that are in your plan’s network. If you need a specialist, such as a cardiologist (heart doctor), a referral from your PCP is required. Generally, an HMO won’t cover services from an out-of-network provider. Preferred Provider Organization (PPO)This plan allows you to manage your own care, with or without referrals from your PCP. You can choose which provider you want, whether they are in or out of network. Point-of-Service (POS)The Point-of-Service is like a combination of HMO and PPO. Like an HMO, you choose a doctor, also called a primary care provider (PCP). But like a PPO, you can get medical care from both in- or out-of-network providers. You’ll pay less when you use a doctor or hospital in network and more if you choose out of network. High-Deductible Health Plans (HDHP)This plan gives you the most control on how your healthcare dollars are spent. A High Deductible Health Plan usually has a high deductible but a low monthly premium and a special spending account to help you save money for healthcare expenses. These special accounts include health savings accounts (HSAs), health reimbursement account (HRAs) and flexible spending accounts (FSAs). Metal categoriesHealth plans are broken into categories named after metals: Bronze, Silver and Gold. These categories reflect how you and your plan share the cost of your healthcare. The plan you select has nothing to do with the quality of care you receive — but rather how much you pay for healthcare services. A Bronze plan is ideal for people who don’t plan on using their insurance very often and a Gold plan is good for people who use the healthcare system more often. BronzeA Bronze plan will cover about 60% of your medical costs. SilverA Silver plan will cover about 70% of your medical costs GoldA Gold plan will cover about 80% of your medical costs The more your insurance company pays, the higher your monthly premium will be. Bronze
Silver
Important: If you qualify for “extra savings” (sometimes called “cost-sharing reductions”) on your deductible, copay, and coinsurance, it might be best for you to pick a Silver plan. You can save hundreds or even thousands of dollars per year if you use a lot of care. Gold
Is the high deductible plan worth it?If you're relatively healthy and generally don't have medical expenses beyond annual physicals and screenings, you're more likely to save money by opting for an HDHP over a low-deductible plan. That's because yearly checkups and screenings count as preventive services, which HDHPs typically cover.
Who is a high deductible plan good for?A high-deductible health plan might be right for you if:
You're healthy and rarely seek medical care for illness or injury. You can afford to pay your deductible upfront or within 30 days of receiving a bill for that amount if a surprise medical expense comes up.
What is Blue Shield HDHP?Shield Savings Plan is a High Deductible Health Plan (HDHP), so if you enroll in a Shield Savings Plan and are qualified to open an HSA, you can use your tax-advantaged HSA funds to pay for qualified medical expenses, even those not covered by your health plan.
What is the difference between PPO and high deductible?A preferred provider organization plan comes with lower deductibles but higher premiums each month. With a PPO, you pay more money each month but have lower out-of-pocket costs for medical services and may be able to access a wider range of providers.
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