What You Should Know About Health Insurance

Health insurance helps to pay for the cost of care you might need if you get sick or injured. The way most plans work is that you pay a premium up front and in return, the company promises to cover some or all of your medical expenses if you ever need it. In addition to the different types of insurance plans available, other factors that influence the price of health insurance include your age, what type of coverage you need and whether or not you have a health condition. The type of health insurance you choose is important, and there are a number of factors to consider including the deductible, copayments and coinsurance.

A deductible is the amount of money you must pay each year before the insurance company starts paying for your care. This typically excludes preventative visits. You can find out the details of your plan by looking at your member contract, also known as an Evidence of Coverage booklet for private health insurance or a National Benefits Statement for government-run health insurance.

Some health insurance plans require you to select a primary care doctor who will coordinate your medical care. These are called Health Maintenance Organizations, or HMOs. Other health insurance plans, such as Preferred Provider Organizations, allow you to choose your own doctors and hospitals and will usually cover services provided by out-of-network providers (though you may pay more). There are also plans that combine features of both HMOs and PPOs, like the Point of Service (POS) plan, which allows you to see any provider but you will usually pay less if you use in-network providers.

If you have a serious health condition, you will need a comprehensive plan that covers most of your potential expenses. A comprehensive plan might be more expensive, but it can help to keep you out of financial hardship if you must spend a lot on health care.

In general, health insurance plans with higher premiums offer more extensive coverage. However, it’s also important to look at your budget and lifestyle before choosing a plan. If you do not have any major medical concerns, a basic plan with lower costs might be best for you.

The type of health insurance you have is also influenced by your location, as insurance rates are based in part on how many claims are filed in the area. You should also be aware that there are some conditions and treatments that have a waiting period, during which time the health insurance company will not cover the cost of treatment.

Whether you are shopping for individual or family health insurance, you can compare different plans and prices using the Marketplace or other online resources. A health insurance broker can also help you navigate the process. At Univera Healthcare, for example, we can help you shop for and enroll in a plan that fits your unique needs. We have offices across New York State, so we are able to provide assistance regardless of where you live.