If you’re interested in choosing a new health plan, it’s helpful to know about the different types of health insurance plans available. By reading the summary of benefits, you can find out what the various plans offer and which ones may be the right fit for your needs. Many HMO plans have a primary care physician who manages your medical care. While this can be a convenient service, in many cases you will have to make referrals to see specialists.
For the most part, your health plan will cover preventive care, such as annual checkups. If you do, you’ll pay no out-of-pocket costs for preventive care. However, you may need to pay a copay for services that your plan doesn’t cover. You may want to consider an HSA, which can be set up to pay for coinsurance and other medical costs. In 2020, the maximum HSA contribution will be $3,550 per individual or $7,100 for a family.
A health insurance plan pays a certain percentage of the average person’s expenses. The amount of the deductible varies, depending on the type of plan you choose. The lowest-cost health insurance plans often have the highest deductibles. Most people are not sick enough to have high deductibles, but a catastrophic health insurance policy pays once those deductibles are met. For preventive care, catastrophic health plans must pay a portion of the deductible, so you may want to consider a catastrophic plan instead.
Infertility treatment may include assisted reproductive technology (ART) procedures and artificial insemination. Non-surgical procedures for infertility include diagnostic testing, donor sperm and eggs, and charges for educational accommodations. Surgical procedures to correct refractive errors are covered. Botanical medicine is not covered. Likewise, nonsurgical procedures for infertility may require a prior authorization. For these services, a physician’s report must be provided within 14 days of the start of the nursing care. These documents are required to be submitted with the claim. A medical consultant for the health plan will review the report and the nurse’s notes to determine whether or not the service is covered.
Some health plans also cover routine care. This includes check-ups, screenings, and patient counseling. You need a primary care physician, or PCP, for the most comprehensive care. A PCP is a primary care provider that coordinates all your health care needs, including hospital admissions and referrals to specialists. Some health plans require a PCP, but not all. You can also request that your health care provider approve a procedure before it takes place. Then, your health plan will pay for the procedure.
You may need to apply for a health plan through the Marketplace if you lost your job. It’s important to note that the Marketplace does not provide the same coverage as COBRA, and only applies to businesses with less than 20 employees. If you’ve been on your employer’s health plan for at least three months, you may be eligible for a subsidy called a premium tax credit. This money can help you pay your premium more easily.
