Choosing a Plan that is right for you and your family can seem like a daunting task.
You should consider any medical needs you foresee for the upcoming year, your overall health, and any medications you currently take. The following scenarios may also help you make an informed decision.
If you are single or married with no children and in good health with no medical needs outside of preventive care…
A Consumer Driven Health Plan (CDHP) or similarly, and High Deductible Health Plan (HDHP) may be a good fit. These plans offer lower premiums and most preventive care is covered at 100% if using an in-network provider. You may also be able to use a Health Savings Account (HSA) with these types of plans, a tax-advantaged account that provides a safety net for unexpected medical costs.
If you are single or married with children and/or have major medical concerns or anticipate a pregnancy or surgery…
A Preferred Provider Organization (PPO) may be the right answer for you. These plans come with higher premiums, but less costs at the time of service and a smaller deductible, meaning your out-of-pocket maximum may be reached earlier in the year. These plans allow you to choose from a network of providers, typically without the need for a referral or use of a Primary Care Physician (PCP).
What about an HMO?
A Health Maintenance Organization (HMO) may be your best option if lower costs are most important, and you don’t mind the restriction of seeing a PCP first for any referrals to specialists that you might need. HMOs will generally not cover any out-of-network expenses unless it is an emergency.