I need help buying health insurance!!!?

Question

I am 23 and for the first time I need to buy health insurance. I'm not familiar with what all of those terms like HMO, PPO, annual deductables, and other terms are. I'm not a sickly person, but I do have a physician I like to go to. So what should I look for and what would be the best plan for me??

Answer 1

If you want to pick your own physicians, choose a PPO over an HMO. It may cost a little more, but the PPO will provide more flexibility. You don't need to see (and pay) a general practitioner first before getting in to see a specialist. An annual deductible is the amount you have to meet in order for insurance to pay. For example, if your deductible is $500, then until you reach $500, they will not pay any claims, or conversely, if you have a claim for $1500, your deductible is $500, so they will pay $1000.

Answer 2

Also HMO's don't generally have out of network benefits if you see a doctor out of the network. PPO plans do have out of network benefits.

Your deductible has to be met before any payments will be made by your insurer. Say your deductible is $300. You pay the first $300 out of your pocket.

Coinsurance is the percentage of the allowance you are responsible to pay. If you insurance company pays 90% for surgery in the office. Your coinsurance would be 10%.

Answer 3

You may Google Assurant Health, or Golden Rule Insurance.

Answer 4

Well it all depends.  The major difference with a HMO & a PPO are that with an HMO you MUST get a referral to go to a specialist. Meaning if you needed to see a urologist, cardiologist, dermatologist you would have to go to your primary Dr. and he/she would have to refer you to another doctor.  With the PPO you can self refer.  Meaning you can simply call the Dr of your choice (preferably IN network for better covereage) and go in to see them.  Note that the Co-Pay is generally higher.  Mine is 15 for Primary care and $25 for a specialist.  Deductables come into play in a varity of ways-for example if you are hospitalized.  (I had kidney stones last month)  My plan (a PPO) covered my surgery at 90%--so I have to pay 10% of the fees.  I would go with a $500 deductable-based on the fee you will pay per pay period.  If you have a Dr. you like--make sure they are IN NETWORK-not simply that they accept your insurance plan.  If they are in network your service will be covered at your copay.  If they are OUT of network you can still go BUT the insurance may only pay 75 or 80% (depending on how your insurance is set up) and you will get a bill for the balance-you might also have to satisfy your deductable PRIOR to them paying any bills.  Hope that's not all too confusing to you.  Good Luck