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Looking for health insurance? 5 things you need to know

Sep 05, 2024
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Buying health insurance probably isn’t among the more exciting purchases you’ll ever make. But like it or not, it’s one of the most important. So, we want to help you get it right.

Here are a few things you need to know:

  • How much will my insurance cost? When you start shopping, you’ll likely first check the price, or monthly premium for coverage. Think of that as a sticker price--just like buying a car. That’s a start, but you’ll also have other out-of-pocket costs, like copays, coinsurance and deductibles.

 Learn more about how to estimate what you’ll need and how to tally how much you’ll pay here.

  • How can I tell if a plan meets my needs? While health plans are similar, they do offer different services or benefits, and sometimes even different provider networks. Some might have wellness plans or dental and vision benefits included. Beyond benefits, it’s really important to know that your insurance company can support you whenever you need it. Unique to Community Health Options for all our Members, for example,  is a care management team that partners with community services to support well-being, such as providing transportation to appointments or even meals for someone who is recovering at home.
  • What do HMO and PPO mean in the plan names? They are types of plans networks. HMO stands for “health maintenance organization,” which gives you access to preferred providers, but you need to stay in that network to get coverage. A PPO stands for “preferred provider organization,” so you can use preferred providers, but have the freedom to use out-of-network providers by paying a slightly higher price.

Understand more about plan types and what they offer here. And see more about Community Health Options’ network here.

  • Bronze, Silver, Gold and even Platinum? Should I just go with Bronze because it’s the cheapest? Maybe, or maybe not. More important, these “metal” categories have nothing to do with the quality of care. Instead, the difference is based on the plan’s share and how much you’ll pay. And it’s important to think about how you’ll use your insurance, so you choose a level that’s right for your needs.

That is, Bronze levels have the lowest monthly premiums but the highest deductibles, while Silver, Gold and Platinum levels cost more up front, but have lower deductibles. It might seem as if Bronze is the way to go if you want to save money, but that’s not necessarily true. Depending on your income, you may be eligible for premium tax credits or cost-sharing reductions. And if you’re 30 years old or younger. you can buy a simple Catastrophic plan.

Learn more about those levels here and how to determine whether you might be eligible to save  money on higher levels than you think you can afford.

  • Is all this insurance lingo confusing? We have a translator! It’s true. The healthcare industry often uses very confusing language. There’s even room for confusion for those of us who work here and are fluent in health-speak. We got you.

    Here’s a crash course on the words you’ll see over and over again as you choose your health plan.

     

Want to talk with someone about which plan to choose for you and your family? Call us at (855) 624-6463 from 8 a.m. to 6 p.m., Monday through Friday, or email us and we’ll get back to you.

Follow @communityhealthoptions on TikTok for quick tips and tricks on how to buy and use a health plan. And don’t forget to follow Community Health Options on LinkedInFacebook or Instagram.

 

 

SEE ALSO

When it comes to healthcare, Maine gets high marks for its quality of care. The trouble is, it’s getting harder for Mainers to access that care.

Recently, a Community Health Options Member needed a new primary care provider after her doctor retired. After a long search, she finally found someone accepting new patients, but faced an eight-month wait for an appointment. Unfortunately, her story has become commonplace. Access to care is no longer a struggle for just the uninsured but has become a universal issue that hits everyone.