1. Network Differences

If freedom of choice & access to the best care are important to you, you want a PPO Network.

This is the largest network option, you don’t need referrals to see specialists, and establishing a Primary Care Physician before receiving treatment isn’t necessary. Also, you still have coverage if you go out of network.

When you are in critical condition, the last thing you should be worrying about is if your provider is in network!

2. Out of Pocket Max/Limit

NOT to be confused with a deductible, which is a specified amount you are responsible for paying before your health plan starts covering your claims.

Once your copay is met, you then pay a copay or coinsurance for healthcare costs until you hit your out of pocket max. This is the most you will spend before your plan starts to cover 100% of covered services for the remainder of the year.

If a policy does not have an out of pocket max, this is a red flag and sign that it simply a limited benefit plan that will not properly protect you when you need it most!

3. Annual & Lifetime max

The highest dollar amount your plan will pay for covered services. It’s critical to choose a plan that offers unlimited maximums for catastrophic covered. Most plans are not allowed to place maximum benefits on essential services but a lot of private plans will have limitations.

4. The Purpose of health insurance

Free annual wellness exam and having a copay for doctors’ visits are all nice benefits, but it is important to understand the true purpose of health insurance:

To protect you against a significant financial loss due to medical expenses and give you access to the best care if & when you need it most.

No one ever thinks they will be the victim of a critical illness or experience a life-changing accident, but the reality is that these things happen to good people every single day.

Don’t get hung up on the small services, especially if you are healthy and don’t use your coverage regularly. Strong catastrophic coverage is ultimately what will protect you against bankruptcy and offer you true peace of mind.

5. Your AGent

Your agent should be accessible to you not only in the search for a health plan, but throughout the duration of your policy. You do not have to wait on hold to talk to a different customer service representative every time you need assistance. The ability to call or send a text to your agent when you need them is invaluable.