Navigating the World of Health Insurance

By Maryl Joop


In late June of 2012, the Supreme Court of the United States of America voted to maintain a controversial provision of the Affordable Care Act, commonly called Obamacare, which will require each individual in America to buy health insurance with the penalty of a fine if they fail to do so.

These complications when settling on an insurance plan are made even more difficult when an individual is deciding between health insurance policies. Health insurance is its own beast within the already puzzling insurance industry and choosing the right health insurance plan may be a difficult challenge for some people.

Purchasing health insurance, even for those who are somewhat familiar with healthcare procedures, can be an extremely difficult and stressful situation as buying the wrong coverage can be just as financially disabling as buying

excessive coverage that costs more in premiums than an individual can afford. This is because if a person buys an insurance plan with insufficient healthcare coverage it can lead to extensive out of pocket costs should a hospital visit or extended care treatment not be covered by the insurance policy.

Some insurance policies can be pretty complicated and working with a professional to sift through your options may be exactly what you need. Finding a policy that balances coverage with premium prices may take some time, but will be well worth it in the long run.

PPO policies, or Preferred Provider Organizations, also have networks of available physicians, but they will allow the subscriber to go outside the network for their healthcare needs for a higher fee. PPOs are the typically right choice for those who can afford a higher out of pocket cost because they give the liberty of flexibility when choosing health care providers.

Like almost all other industries, healthcare insurance operates within its own language and a foundational understanding of that language will provide the shopper with knowledge and power when deciding what policy to purchase. Some of the basics include a deductible, or the amount of out of pocket expense you pay before the insurance plan contributes, and co-pay, which is a fixed amount of money the policy holder agrees to pay for some services like prescriptions or hospital visits.

All of the above types of policies offered by health insurance companies have their own advantages and disadvantages but the primary give and take comes from flexibility and cost. Typically, the less out of pocket costs are attributed to the subscriber the less flexible their options in available physicians will be.

Decide before hand what types of coverage you will need and what types of situations your health care plan will need to be prepared to cover. Balance these needs with your budget to decide what plans you can afford and what kinds of coverage you could do with out to save money.

New insurance buyers are not the only ones who should research and plan for additional healthcare coverage. For those who are on Medicare, supplemental insurance for Medicare should also be explored and considered as an option to cover all needed aspects of healthcare costs.

Health insurance can be complicated and intimidating, but if you invest a little time and effort in the process of finding the policy that is right for you, you may surprise yourself with what you can find. Take a look at your policy or assess your needs and start looking for your first policy, you won't regret it.




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