Health insurance is complicated, and sometimes searching for a plan can leave you with a lot more questions than answers. Purchasing a health insurance plan is a huge investment, so you need to make sure that you ask your agent the right questions before you spend your hard-earned money. EZ.Insure wants to make the process easier for you, so we have answered some of your most common health insurance-related questions.
How Much Does It Cost?
There are many different costs to consider when purchasing a health insurance plan.
This is one of the hardest questions to answer, because the amount you spend on healthcare will depend on your:
Premiums– When you purchase a health insurance plan this is the first bill that you’re going to get. It’s the amount that you pay every month to stay covered and keep your health insurance. This amount is calculated based on your age, tobacco use, plan type, and number of dependents covered.
Copays– This is a set fee that you have to pay when you see a doctor or specialist. Depending on your plan, you will have different copays for doctor visits, specialist visits, and prescriptions.
Deductible- This is the amount that you have to pay for covered services before your health insurance begins to pay. For example, if you have a deductible of $1,000, and you have surgery that costs $10,000, you will have to pay your $1,000 deductible and then your health insurance plan will begin to pay their share.
Coinsurance– The percentage of allowed charges for covered services that you have to pay. For example, some plans will cover 80% of the costs of services, and you will have to pay the other 20% after you meet your deductible. In the example above, if you had an 80/20 plan, you would pay 20% of the remaining $9,000, or $1,800.
Out-of-pocket maximum– This is the maximum amount of money that you have to pay for covered services during a benefit period, which is usually a calendar year. So, in the example above, you would have spent $2,800 on your surgery – if your plan has an out-of-pocket maximum of $5,000, then you would be more than halfway to meeting your maximum. If you spent $2,200 more on healthcare costs in the course of that year, your insurance plan would begin paying 100% of your costs.
This is a lot to take in, but EZ’s highly-trained agents can help you balance your financial needs and health needs, and find you an affordable, quality plan. They will go over each and every one of these costs in all available plans, and will even help you find discounts and subsidies that can help you pay for your health insurance.
What Type Of Plan Do I Need?
Determining which plan coverage is right for you depends on your health and your financial situation. When it comes to ACA plans, there are four main categories, or metal tiers: Platinum, Gold, Silver, and Bronze. These categories basically determine the ratio of your premium to your deductible. If you want to keep your monthly premium bill low (but have a higher deductible), then a Bronze or Silver plan is best for you. But if you have some serious health conditions that require treatment, prescriptions, tests, or surgery, then a Gold or Platinum plan with a low deductible (and higher premium) is a better choice to keep your out-of-pocket costs down.
The most common types of plans are what is known as managed care plans, including PPOs and HMOs. PPOs have a more flexible network of providers that are considered in-network, while HMO plans require that you choose a primary care physician and get referrals for in-network specialists.
If you’ve been going to the same doctor for years, then it’s only natural to want to make sure that you can continue to see them. So, when searching for a plan, you need to check that your primary care doctor is in the network covered by your plan. If you do go to any doctors that are out of your health insurance plan’s network, you will end up paying for the visit out-of- pocket, and that can be very expensive.
Our agents will make sure that your primary care physician is covered in the plan that you choose. We will go over all the plans within your area within minutes and search for your physician in each of these plans to make sure they are part of the network.
What Happens In Case Of An Emergency?
Accidents happen, life is full of uncertainty, and in the event that you need to go to the hospital, you want to make sure that you are covered. Some plans will require you to contact your primary care physician within 24 hours of an emergency room visit in order for your expenses to be covered. If that seems like it is too much to remember during an emergency, then we can find you a plan that does not have this requirement.
Are There Any Perks?
Some health insurance plans do include perks, such as free gym memberships. Some offer discounts for people who are on the right track to getting healthier, and many allow you to see your doctor virtually with telemedicine. That’s right, feeling under the weather? Call your doctor and get your prescription medication sent to your pharmacy without having to go see them in person. No waits, no headaches, just the ability to talk to your doctor or see your doctor, in the comfort of your own home.
Make sure that the health insurance company that you choose has excellent customer service.
Who Do I Call When I Need Help?
You should also make sure that the health insurance company that you choose has excellent customer service. All too often, people call their health insurance company and either get the run-around, get the wrong answers, or hang up leaving more confused than when they called. This can be especially frustrating when you’ve received a large bill in the mail and have no idea why you received it. EZ understands this frustration, which is why our agents work with the top-rated health insurance companies in the nation. We will find you a health insurance plan with a company that has a proven track record of great customer service, and that will be ready, willing, and able to answer all of your questions.
We understand that health insurance is complicated and confusing. That is why we have agents ready to help search and compare plans from top-rated companies across the nation, for free. Our main goal is to help you find great health insurance that is affordable and that meets your health care needs. To compare quotes within minutes, simply enter your zip code in the bar above or to speak to one of our licensed agents, call 888-350-1890.
The cost of health care continues to rise every year, making it harder for many people to afford their medical bills. Data collected over the years shows that doctor visits for people under 65 years of age have dropped over 25%. In the years 2008 to 2016, up to 46% of the adults went at least a year without visiting their primary care doctor. Why? Well due to the rising health care costs, people are opting out of going to see their primary care doctor.
The majority of people just cannot afford the out-of-pocket expenses that accompany a visit to the doctor. Costs for things such as copays or lab work can become prohibitively high for many people to afford. However, primary care is effective in prevention of disease, and going without seeing your doctor can exacerbate an existing health condition.
“There is a lot of data showing that when you raise health care costs, people will receive less care.”
More Money, More Problems
When things go up in price, people tend to shy away from spending the extra money. This does not exclude health care costs. The more money people have to pay, the less likely they are going to go to seek medical attention.
“There is a lot of data showing that when you raise health care costs, people will receive less care,” Dr. Kimberly Rask, chief data officer at Alliant Health Solutions, wrote in an editorial accompanying the study. “But it doesn’t mean that they only stop unnecessary care. They will reduce both necessary and unnecessary care.”
“When patients have to pay more, they may pause, and they may not go in if they don’t think it’s that urgent,” says Nadereh Pourat, a professor of health policy and management at UCLA’s Fielding School of Public Health. But health problems can worsen, she adds. “You don’t want them to wait til things get really bad.”
The Benefits of Primary Doctor Visits
Going to your primary doctor has many health benefits. They keep your health on the right track and help manage conditions.
A primary care doctor may be able to pick up on, and test for, an underlying problem that a person is unaware of. It can be harmful for people not to see their doctors at least one a year, especially if they have a chronic condition that needs to be managed, such as high blood pressure.
During your annual physical, your doctor will also go over your current medications. This is to determine whether they are working or whether changes need to be made to them. Doctors will also keep you from making the mistake of taking two medications together, which could cause a dangerous drug interaction.
“Primary care has all kinds of benefits,” says Dr. Ishani Ganguli, Harvard assistant professor of medicine and physician in general internal medicine and primary care at Brigham and Women’s Hospital. “Both for patients but also for populations,” Ganguli says. The research shows that people are more healthy when they see a primary care doctor for routine care. Where there are more primary care providers per capita, death rates drop for heart disease, cancer, stroke, and other illnesses. Not only do the death rates decrease, but life expectancy goes up.
Although health care costs are on the rise, it is still very important to visit your primary care doctor at least once a year. It is necessary to stay on top of your health, and live a longer life. At the very least, an annual visit will bring you peace of mind. In the most extreme cases, it could save your life.
