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Types of Health Plans

Hello Everyone –

Hopefully you will find this information helpful when considering your health coverage options.

Let’s dive in!

In health insurance, I frequently am asked, “What defines good coverage?” As a health insurance advisor, I am most concerned with preventing my clients from declaring bankruptcy due to expensive medical bills. To protect against this, I recommend all families be on a health plan with a maximum out of pocket. This is key to protecting a family against a $100,000 medical claim. Instead of owing the full $100,000 claim, that family is only required to pay their maximum out of pocket (MOP).

Insurance plans to avoid are any that have no maximum out of pocket (MOP). Often, these plans can seem appealing up front for several reasons. First, there is often a large price difference. The plans that have no catastrophic protection are cheaper because the insurance company’s risk is finite. Second, the network may be larger. This may allow a certain doctor to be in network that wouldn’t accept Obamacare/Marketplace plans. However, despite these benefits, you are putting yourself at extreme financial risk.

Insurance plans to search for have an out-of-pocket maximum and have your desired doctors in network. In most cases, a PPO (preferred provider organization) plan is the best option. However, PPO Plans on the marketplace are different that employer coverage plans by one crucial variable: out of state coverage. The marketplace plans do not cover out of network and the coverage does not travel state to state.

An educated client is the best kind of client, so I appreciate your time reading my post. I hope you have learned more about the health insurance industry. Feel free to reach out to me and get any questions answered: big or small!



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