Choosing your insurance

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Learn about health insurance

Choosing your insurance:

Now that you have a basic understanding of what types of health insurance plans may be available to you, the next step is to help you to choose an insurance plan based on your preferences. As you can imagine, choosing between the various plan types will pretty much come down to cost versus choice. There is no perfect solution and you may decide to opt out of any coverage altogether. However, we can offer suggestions to you based on your preferences. This is not an exact science, but we hope this helps you to think through your options.

You should consider the following factors when purchasing health insurance: the monthly cost of the insurance premiums, the flexibility of the health insurance plan, and the likelihood of seeking extensive medical care in the coming year, which may result in out of pocket costs. Many people are often surprised how much money they owe, even though they have insurance, after a visit to their medical provider.

Insurance Plan	Cost of Insurance Premiums	Flexibility	Estimated cost of future treatment
HMO	Typically slightly less expensive than a PPO	Less flexibility in visiting the provider you want, when you want	Will minimize your out of pocket costs
Traditional PPO	Typically slightly more expensive than an HMO	Greater flexibility in choosing your provider	Moderate to significant costs due to a deductible and co-pays
High deductible Plan	This offers the lowest monthly premiums	You will have the same options as a Traditional PPO	Expect out of pocket costs, especially your deductible, to be high
POS	Similar cost to HMO and PPO plans	You have a primary physician but have the flexibility to go in or out of network	There is no deductible and there tend to be low co-pays
Indemnity	Most expensive plan	The most flexibility to see whomever you choose	Because there are no pre-negotiated rates, this tends to be very expensive

Making your choice: Ultimately, the choice often comes down to cost for most people. If you are struggling to make ends meet, your only choice may be to pick a high deductible plan because you can’t afford the monthly premiums of other plans. However, if you can afford to consider other options, you should consider the plan's flexibility and the potential out of pocket costs (see our Care Caculator for more information). Here are some common examples of how people might choose:

	Example 1: If you are single, young and healthy, you might choose a high deductible plan because you don’t expect to need to use your insurance. If this is the case, the money you save on premiums can be set aside in case you do incur a healthcare expense and need to cover a large deductible. Other people with this profile might choose to opt out of insurance altogether, but remember that this is risky as you will have significant out of pocket expenses if you become ill.

	Example 2: You may be expecting a child this coming year. You’re probably better off choosing an HMO or a Traditional PPO. While you may pay higher premiums on a monthly basis, you will likely need multiple health care services both before and after the child is born, and your co-pays and deductible will be much more manageable under these types of plans.

	Example 3: You are facing a chronic and costly condition. In this situation, you might end up choosing an HMO or a high deductible PPO. With the HMO, you make your monthly insurance payments and your insurance company pretty much takes care of the rest. With a high deductible plan, you might have to pay the first $5,000 of the bill to meet your deductible, but many plans will cover 100% once you’ve reached your deductible or out of pocket maximum and the monthly insurance premiums will be more affordable.

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