Yes! You can certainly find lists, of all the health insurance providers in the universe, on line. A recent list of the top 25 U.S. providers, ranked by size, can be found at the U.S. News and World Report website. First on the list is the UnitedHealth Group, of Minneapolis, Minnesota.
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The problem is not finding a list of companies, but making a wise choice when shopping for health insurance coverage. How do you sort through a tangled web of insurance providers, to find the program best suited for you and your family?
The important topics below will help you begin the search process and focus on the elements most crucial to your family’s health and well-being. Shopping for health insurance can be an arduous and time-consuming task, but it is well worth your time to thoroughly investigate all the health plans in your area.
Are health insurance companies the same across the country?
No! Health insurance companies are required to obtain licenses in each U.S. state in which they do business. Many of the largest companies provide coverage to residents of a single state. Other companies may write policies in ten or twelve states. Some agencies may only serve one town, city, or region in a given state. Rule number one: know your local providers!
What major coverage options are there?
The two main coverage options are HMO, health maintenance organization type plans and PPO or preferred provider organization style plans. The monthly premiums charged for these plans may be similar, but it is wise to explore the features of each plan to see which might best serve your needs.
HMO plans provide all needed and necessary medical services under one umbrella. A network of care providers see to members’ needs, with the subscriber selecting one special doctor to be his or her PCP, primary care physician. The PCP coordinates all medical care and treatment, referring the subscriber to other network providers as necessary.
The HMO group generally pays for all covered services in full, though prescriptions may have small co-payment fees attached. The downside of this system is that some services may not be available in your HMO, and doctors and other medical practitioners outside of the HMO network are not covered at all.
PPO plans also feature a network of providers, but subscribers are free to select the provider of their choice for any covered service. Fees are not fully covered in a PPO plan, leaving subscribers to pay for a portion of each service. These patient portions are called co-payments. There are also minimum total annual out-of-pocket contributions required by most PPO plans. These amounts are called health insurance deductibles and may vary from plan to plan.
What else should I look for in addition to basic coverage?
Add in whatever additional coverage that might be necessary for you and your family. Examples are prescription drug coverage and riders for dental or vision care. Most basic health policies cover a small portion of vision expenses, but nothing of standard dental services.
Not every prescription drug coverage rider is the same. Your company’s formulary will tell you if the drugs your doctor prescribes are covered. Some policies only provide full coverage for generic versions of popular drugs and charge significantly higher co-pays for brand name pharmaceuticals.
What about other members of my family?
You should make sure that all of your dependents have sufficient health coverage, either on their own or through your family health insurance group policy. Legislative changes in 2010 extended a child’s coverage under their parent’s policy to age 26 from age 24. Certain states, including Ohio, have extended this further, to age 28.
Where can I go for help?
There is help all over the Internet! However, many of the websites offering assistance often provide useful and helpful information, but will try to steer you to their preferred health insurance providers.
Look for a health insurance broker in your area. Brokers represent all local insurance companies and present every option to their clients. They are experts in the industry and will be able to compare available options side-by-side. Brokers also provide billing services and other support for local insurance groups.
Remember, this is just the beginning of the process. Finding the right health insurance plan takes time, energy, and effort. Once a decision is made, and a contract signed, that policy will be in force for a full year. Changes can only be made annually, when the policy comes up for renewal, so choose wisely!
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