How Do You Choose the Right Health Insurance?

How do you choose the best health insurance policy? The answer really depends on your situation in life. Someone who is young and single is going to have far different needs than someone who is older and has a family depending on the health insurance. If you are shopping for health insurance plans, here are some of the considerations you need to make.


One of the first choices you may need to make is which structure your health insurance policy will have. The three most common are HMOs, PPOs, and POSs. An HMO, or health maintenance organization, is probably the most affordable option. However, you will have many limitations with an HMO as to which doctors you can visit, and there is often a lot of paperwork you must go through in order to obtain certain medical procedures or get a visit with a specialist. In an HMO, your doctor is paid a set fee each month for each patient under his care, regardless of whether or not a particular patient receives care that month. You are required to visit doctors who are in the HMO.

With a point-of-service, or POS, your insurance provider only pays when you receive services. You have fewer limitations as to the doctors you can see, but you may be required to pay a portion of the cost each time you receive care. You will have slightly more flexibility if you need specialist care under a POS plan.

A PPO, or preferred-provider-organization, is like a combination of the two previous policies. Like an HMO, you are going to be better off if you choose a physician that is part of your network. With a PPO, your insurance will pay more for your care if the provider is in the network. However, unlike an HMO, you can choose to go to a doctor who is out of the network, you will just have to pay more out of pocket to do so. You will also have a deductible and co-pays with this type of insurance.

Deductible Vs. Premium

The deductible, or the amount you must pay out of pocket before your insurance will kick in, directly affects the amount you pay for your premium. The higher your deductible, the lower your premium will be. However, finding the right balance between the two is not always easy.

If you are going to be using your insurance regularly, such as if someone in your home has a pre-existing medical condition or if you have children who need regular checkups, you may want to pay a little more for your insurance premium in order to have a lower deductible. However, if your insurance is to be used for potential major health problems that you might face someday, but right now you are relatively healthy, a higher deductible in return for a lower premium may be more beneficial.

Look at Prescription Drug Coverage

Not all insurance policies have prescription drug coverage. The best health insurance policies will cover your prescriptions. If the policy does not cover prescriptions, find out if it offers a discount plan you can use towards drug expenses.

Look at Lifetime Maximum Benefits

Many insurance products will put a cap on the amount you can receive in benefits. This is called a maximum lifetime benefit. These will apply to individual treatments, such as cancer, mental illness, or organ transplants. If the insurance has very low caps, such as $100,000, you need to find something else. Medical expenses add up quickly, and you do not want to be paying for coverage that is not going to be sufficient if you have a severe medical problem in the future.

Choosing health insurance is never easy. Be sure that you work with a qualified agent who can answer all of your questions. Pose various scenarios to see how the insurance would cover situations that could occur in your future. This will help you choose the best health insurance for your family’s needs.