Best Health Plans – What You Need to Know

Choosing the best health plans can be a confusing experience these days. There is a plethora of quality health plans available for just about every set of circumstances and budget. The key to determining which plan is best for you and your family is to know the various parameters of insurance plans and understand how those parameters apply to your set of circumstances.

There are three primary factors to consider when selecting a health insurance plan:

1. What is the total out of pocket cost per year going to be? This includes a combination of the monthly premiums, doctor visit co-pays, hospital visit co-pays, prescription drug costs, and last but not least, the annual deductible.

2. Which doctors and hospitals are accessible through the plan? Some plans require that you see only doctors in that plan’s network (except for emergencies); other plans allow you to visit any doctor you choose, however, the co-pays on this type of plan are generally higher.

3. What is the reputation of the health plan based on user feedback? This includes the quality of care provided at in-network facilities and also the efficiency of the payment system (you don’t want to be getting bills for incurred costs that should be covered by your insurance).

The most efficient way to compare health plans directly is by utilizing an online comparative service.

The topic of health insurance is probably not a topic that comes up very often for the majority of the adult population who are employed by companies that provide benefits. It becomes a very important and urgent topic if you lose your job and have only a few weeks to decide whether to continue your insurance through your employer (COBRA) or to seek less expensive coverage on your own.

With the economy being as bad as it is, there are many people making a go starting their own businesses as well. There are numerous high quality health insurance programs available for self-employed persons and small businesses alike.

One thing is for certain: all health plans are not created equal, and the quality of your health plan can have a huge impact on the quality of your life; so choose wisely.

This article was written by the owner of Best Health Plans, an organization dedicated to helping individuals, families, and small businesses find the best health insurance plan for their needs.

Dental Insurance and Individual Health Plans

One could rarely find and buy individual health plans that also cover dental care. There is useful information that people should know especially if they consider buying the policies separately.

It is estimated that about 45 million Americans currently do not own any dental insurance policy. Most non-elderly citizens who own individual health plans also own dental care policies. However, majority of people who buy health insurance plans on their own do not have dental insurance. This data is according to a report released by Centers for Disease Control and Prevention.

While individual health plans cover several added services like basic emergency care as well as costs of prescription drugs, they logically are not required to include coverage for adult oral care. However, for health care insurance policies for children, dental services are required.

In March 2010, reforms to the healthcare insurance were set. However, despite the push exerted by many advocates, that bill did not include a wider dental component. Supporters and proponents of the reform argued that individual health plans already cover costs for other pressing health conditions like diabetes and heart diseases.

About 75% of 172 million Americans under the age of 65 years (who own private health insurance policies) have dental insurance plans as well. Their employers mostly provide the health insurances. Among those with separate dental coverage, more than a quarter of them have comprehensive plans with dental insurance while a quarter have stand-alone plans. Some have both.

About 90 million American citizens own individual health plans through Medicaid and Medicare, which both do not offer dental care plans for adults. There is no figure available pertaining to public health insurance plans. Medicaid shoulders dental care for people under 21 years old. The insurer currently serves up to 45 million people belonging to the low-income group. However, such patients complain about troubles in finding accredited dentists.

A separate government-sponsored program provides dental care, albeit limited. It is the Children’s Health Insurance Program. As for the older people, they could always opt to purchase separate dental care policies from health insurers.

Do you look for health insurers that also offer dental care plans? Data from the Association for Health Insurance Plans reveal that there are only a few insurers that do so. Those include Cigna Corp, Aetna Inc, Assurant Inc, Humana Inc, and UnitedHealth Group Inc. The association represents up to 80 of overall dental insurance plans in the US. There are also health insurance plans that offer dental coverage as part of health policies. They include several and specific plans from MetLife, Principal Financial Group Inc, and Blue Cross Blue Shield Association.

Experts advise people to buy dental care insurance policies even if they already own individual healthcare plans. Purchasing separate plans is more advisable especially because it would be very hard, if not impossible, to find and buy health insurance policies that also include dental coverage.

Best Individual Health Plans For You

If you work for yourself, or if your company does not provide a group medical benefit, you probably need to shop for an individual health plan. This plan may just cover you, or it may also include your spouse and/or children. Insurers have developed many types of medical coverage to suit different types of customers, but it can be difficult to determine which plan will provide your family with satisfactory coverage at an affordable price. Let’s look at the major types of health insurance plans on the individual market today.

PPO (Preferred Provider Organization) – PPO health insurance plans are very popular because they have a network of medical providers to control costs, while allowing consumers to leave the network if they accept a lower level of coverage. In general, you will still get network coverage if you need to seek medical services for an emergency, even if you go outside the network. If your network does not provide a certain medical service which your need, they may also coverage that service at the network rate. However, you will need to get that service pre-authorized to be sure.
HMO (Health Maintenance Organization) – An HMO provides managed care where the health insurance company controls costs by only covering network provided health care. Again, an HMO will generally make an exception for emergencies or for certain services that are not included in their network.
HSA (Health Savings Account) – An HSA plan has two parts. One is a high deductible major medical plan, and the second is a savings account. HSA contributions can be deducted from taxes (within limits), earn interest, and roll over from year to year. The high deductible health plan may include a PPO network to help control costs.
Indemnity Health Insurance – This is a traditional health insurance plan that simply provides health insurance coverage for amounts over the deductible, and under the maximum specified in the policy.
Specified Benefit Plan or Mini Med Plan – The plans outline specific benefit amounts for different medical services. They may have lower deductible amounts than major medical plans, but tend to have much lower maximum limits for medical services.
So, which health plan is best for you? You need to consider your own expectations, needs, and budget. Your health insurance plan will not do you any good if you need to cancel it because the premiums cost too much. You may need to accept a higher deductible or more cost sharing than you desired in order to reduce monthly payments. When you buy health insurance on the individual market, you will certainly look at it differently than when an employer contributed a large portion of the premium.

If you live near a large HMO network provider, you may find that managed care really helps you control costs. However, many people enjoy the flexibility of a PPO because it still controls costs but does not require them to seek every treatment from the medical provider network. HSA plans work well for good savers because they allow the covered people to participate in the cost control process.