Health Care

Choosing a Health Plan

With the countless options available and the complex terminology and paperwork, selecting a health care plan can be overwhelming. There are two basic types of plans: group plans (plans supported by an employer) and individual plans (plans not supported by an employer). Whether you have access to a plan supported by an employer or you need an individual plan, these tips for selecting a plan can help.

Before choosing a plan, ask yourself:

• How much can you afford to pay monthly for health care?
• Who requires coverage under your plan (just you, and a spouse or dependents as well)?
• How often do you, your spouse, and children visit the doctor?
• Do you want or need dental and vision coverage?
• Do you or your dependents have medical conditions that require specialized care?
• What would happen in the event of an accident or surgery?
• What is the maximum deductible you could afford to pay?

Knowing the answers to these questions can help you understand your health care needs and financial considerations. If you or a family member has a pre-existing health condition, it can be more difficult to get the health coverage you need. As part of the Affordable Care Plan passed in 2010, there is a Pre-Existing Condition Insurance Plan (PCIP) available. You can find out more about it here.

Managed Care Health Plans

Here is a brief explanation of some of the most common Managed Care health plans:

• HMOS (Health Maintenance Organizations) are a type of health insurance plan where coverage is limited to doctors who work for or contract with the HMO. A primary care physician generally oversees your care and must refer you to specialists as needed.
• PPOs (Preferred Provider Networks) allow subscribers to use doctors, hospitals and providers outside of the network for a fee.
• High-Deductible Health Care Plans are high-deductible plans with low monthly premiums, designed to offer minimal day-to-day coverage but to protect you in the event of a catastrophe.
• Point of Service Plans combine some aspects of PPOs and HMOs. Like PPOs, they generally require users to choose a primary care physician, who can make referrals to other doctors inside or outside of the network.
• Fee-for-Service Plans reimburse you for a large percentage of what you pay out of pocket. You pay the bill for services; then your insurance company pays you back.

After choosing your plan and services, make sure to use them wisely. Most health insurers supply educational materials on preventive care such as quitting smoking, weight loss and chronic disease management.

Staying Healthy

In addition to making life more enjoyable, living a healthy lifestyle is key to keeping healthcare costs down. People who live a healthy lifestyle tend to be more productive and better at handling stress, making them more valuable employees. Being fit can even save you on health insurance - many companies factor in height and weight when determining rates for consumers. Making healthy choices, like quitting smoking, can also help to keep your health care and medical insurance costs done.