The best health insurance policy would be one that has a good network of Doctors, medical services, and hospitals.
More importantly one that your Doctors accepts, covers all your medications, has a low deductible and maximum out of pocket, and cost less than 10% of your monthly income.
The cost of health insurance depends on a few important things: age, how many people are on your plan, plan type, your zip code, and how much coverage you’re looking for.
The older you are, the more you’ll pay for health insurance.
PLAN COVERS ONE PERSON OR FAMILY
If you’re just insuring yourself, your monthly premium will be lower compared to covering your spouse plus dependents.
Location price is mostly based on the population size in your city, zip code, or county and the age breakdown in that area.
The type of plan that will cost you more is a PPO plan. Less expensive plans are HMO and EPO.
PPO – Preferred Provider Organization basically means it will cover in-network and out-of-network providers.
HMO – Health Maintenance Organization basically means it will only cover in-network providers and you need a referral to see a Specialist from your Primary Doctor. Out-of-Network coverage for Emergencies.
EPO – Exclusive Provider Organization is similar to an HMO plan only covers in-network providers, but it allows you to go straight to a specialist whenever you want.
Copay is a flat fee that you pay when you receive specific health care services, such as a doctor visit, generic medications, and some medical services. Copays range from $0 to $120 depending on the plan and coverage.
Deductible is the amount you pay for health care out of pocket before your health insurance kicks in and starts covering the costs. Usually the deductible applies to high cost medical services such as emergencies, hospitalization, MRI, Ambulatory services, and others based on plan.
Coinsurance is the percentage of your medical costs that you actually have to pay after reaching your deductible. After you met your deductible ($2,000, $5,000, $7,500, $10,000, $12,000 or other), your split medical services cost with the insurance company. Typical coinsurance 80/20, 70/30. If you have a 80/20 coinsurance means the insurance company pays 80% and you 20% of medical services cost until you reach the Out-of-Pocket Maximum.
OUT PF POCKET MAXIMUM
The Out of Pocket Maximum is the most you’ll have to spend for covered services in a given year.
The maximum out-of-pocket limit for ACA Plan (aka Marketplace, Obamacare ) for 2021 is $8,550 for individual plans and $17,100 for family plans.
Choosing the right health insurance plan for you or your family can feel like a daunting task. There are so many options out there that it can feel like you still have so many questions about cost, coverage, and where to find the best plan.
Big and Small Companies are required to provide group health insurance for full-time employees. With a group plan, your employer pays for part of the costs, leaving you with a lower premium. The monthly premiums can even be deducted directly from your paycheck, and you can often add your spouse or dependent to your plan for an additional cost.
INDIVIDUAL or FAMILY HEALTH INSURANCE
Self-employed people and those who do not get coverage through work can buy Individual and Family health insurance plans on the Marketplace.
I, Armando Wilson can help you find and compare your options. Also help you understand the Marketplace or even what your employer is offering you.