Healthcare 101: How to Find the Best Health Insurance Plans

Updated on August 21, 2019

Over 90 percent of the American population has some form of health insurance. Some people buy their own health insurance plan. Others have health insurance through their employers.

The number of people without health insurance has been dropping. By contrast, the number of people who don’t have enough health insurance has been rising.

The best way to avoid being underinsured is to make sure you have a plan that truly meets your needs. That may mean seeking an alternative or supplement to employer-based insurance.

How can you be sure you’re considering the best health insurance plans? Our guide will help you do just that.

Determine Your Needs

Before you begin to look at health plans themselves, you should consider what you need. Every individual is unique, so the “best” plan varies from person to person.

Think about the difference between an elderly man and a young new mother. These two people have vastly different health concerns and needs. The right plan for each of them will likely be a different plan.

If you have current health concerns, then it may be easy to determine your needs. For example, if you wear eyeglasses, you’ll want to find a plan that offers vision care.

Health in Future Tense

Needs can be more difficult to determine for younger, healthier people. They may feel they don’t need health insurance.

A good rule of thumb in this scenario is to think about the “what-ifs.” What would happen if you were injured in a car accident while commuting to work or while skiing on vacation? What if you get married soon?

Life is unpredictable. Health insurance protects against these “what-ifs.”

Some events are more likely than others, of course. If you never ski, it’s unlikely you’ll be injured in a ski accident.

If you’re in good health, a plan with lower premiums may be the right choice.

Sort Through the Alphabet Soup

The next step when choosing health insurance is thinking about the different types of health plans. It can be a bit difficult to sort through the different acronyms:

  • EPO, or exclusive provider organization
  • PPO, or preferred provider organization
  • POS, or point of service plan
  • HMO, or health maintenance organization

These different plans place different restrictions on the professionals you see. An EPO requires you to stay within their network of providers, except in emergencies. PPOs allow you to choose any provider, although in-network care is less expensive.

Most plans keep a directory that you can review before you sign up. If you have preferred practitioners or want to make sure there are medical professionals in your area, check out the plan’s directory.

Think About the Costs

When wondering how to choose a health plan, many people think about the premiums. Cost can be a big factor in finding the right plan, but it shouldn’t be the only thing you consider.

A low-priced plan may not provide all the coverage you need. By contrast, a robust plan with a high premium may offer the coverage you’ll never use.

Beyond Premiums

Be aware that the premium may not be everything you pay. Some plans have low premiums but high deductibles. That means you may need to pay $500 or $1,000 before your insurance will kick in.

Other plans have co-pays. Any of these terms will leave you paying out of pocket, even though you have insurance.

If you buy health insurance outside of the state or federal marketplace, you may go to a private exchange or an insurer. In some cases, this may be less expensive. You will lose any premium subsidies you’d be entitled to though.

Plan Tiers

In the federal marketplace, plans have tiers: bronze, silver, gold, and platinum.

The tiers have nothing to do with the quality of care you’ll receive. Instead, they break down how you and the insurer share costs.

In the bronze plan, you’ll pick up 40 percent of the tab. At the other end of the scale, you’ll pay just 10 percent while the insurer picks up 90 percent. Premiums for platinum are much higher than bronze plans, as you might expect.

Compare the Benefits of the Best Health Insurance Plans

Once you’ve looked at the costs and type of plan, it’s time to compare the benefits of each. These individual plans will offer different coverage.

This is one of the most important steps in the process. You may want to ask specific questions, designed to help you choose between plans.

Think about your current health needs. If you take a certain medication, do any of the plans cover it? If so, how do they cover it?

If you’re concerned about injury recovery, you might want to look at how physiotherapy is covered under the plan.

Don’t forget to think about your family’s needs as well as your own. You may not wear eyeglasses, but one of your children may need to when they start school. Will you have coverage?

Ask About Paperwork

When asking how to choose a health insurance plan, people often forget this step. Some plans are managed, which means they’ll handle the paperwork for you. Others won’t.

Filing claims, especially for out-of-network care, can be a time-intensive and confusing process. If you’re not sure you can handle it on your own, finding a plan that will fill out the forms for you is a good idea.

Prepare for the Healthcare of Tomorrow

The best health insurance plans meet your needs, but they’re also forward-thinking. As medicine and technology continue to leap forward, insurance plans will need to keep pace.

Take a look at some of our articles to discover how the world of medical treatment is changing. Then make sure your insurance plan offers coverage for the treatments of tomorrow.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.