Choosing a healthcare plan is a necessity. Health insurance saves you from paying high medical bills. Many times expenses hit you suddenly. If you have a healthcare plan, you can reduce some of the costs a medical condition can bring. A healthcare plan also gives you access to preventive care to stay healthy.

Choosing the Best Plan

Choosing a healthcare plan can be overwhelming. Many options exist, and picking the right plan is essential. However, you also want to avoid spending more than you have to. Here are tips for choosing the best healthcare plan.

Comparing Networks

A healthcare plan network is a group of doctors and other providers that an insurance company contracts with. Choosing an in-network provider means the insurance company covers some of your expenses at an agreed-upon rate. You pay more if you see a provider outside the network.

If you have doctors you already see and don't want to switch, you need to determine with what healthcare plans they contract. Otherwise, you may end up paying out-of-network rates to continue seeing them.

Another thing to think about is the size of the network. The more healthcare providers the network contracts with, the better your choices. Larger networks may also be working toward a digital transformation for healthcare, and you may be able to digitally access your medical records, make appointments and get lab results.

Checking With Your Employer

If you or your spouse's employer offers a healthcare plan, it may be your best choice. Companies that provide healthcare usually cover part of the monthly premiums. You will probably pay less for coverage than by purchasing it yourself.

Finding Government-Sponsored Healthcare

If you cannot get coverage through an employer, you will need to check with your state's online marketplace if it is available. If not, the federal marketplace offers healthcare options. You can start by going to HealthCare.gov. The site will direct you to your state's plan if one is available. If not, the site will take you to the federal exchange.

You may receive premium tax credits with a qualifying state or federal healthcare plan. They are based on your income level and can help you pay for your insurance.

Choosing a Private Insurance Plan

You can purchase healthcare from a private insurer or an exchange. This option is probably the most expensive. You pay the whole premium on your own, and you don't get the tax credits that a government-sponsored plan offers based on your income.

Selecting a Plan Type

Some insurers offer different types of plans. Each plan type differs by how much you pay out-of-pocket and what doctors are covered. The most common plans include the following:

  • HMO: A health maintenance organization plan has lower out-of-pocket costs. However, you have a primary doctor who coordinates your care. You must have referrals for specialty care and procedures.
  • PPO: A preferred provider organization has higher out-of-pocket costs. You have more provider choices and usually don't need referrals for specialty care.
  • EPO: An exclusive provider organization usually does not require referrals. You also have lower out-of-pocket expenses. However, you have to stay in-network to get coverage except in emergencies.
  • POS: A point-of-service plan requires a primary doctor to coordinate your care. It also requires referrals for procedures and specialty care. However, you have more provider options.

Making a Decision

Ultimately, the best choice considers how often you and your family need healthcare. A young, single person with no chronic conditions probably needs an entirely different plan than a growing family with varying healthcare needs.

Whatever healthcare you choose, go over your options carefully. Crunch some numbers if you need to, and consider any possible conditions you may face. Finally, talk to your employer or plan representative if you have questions.