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Frequently Asked Questions About Health Insurance

What is the best health plan for me?
Choosing between health plans is not as easy as it once was. Although there is no one "best" plan, there are some plans that will be better than others for you and your family's health needs. Plans differ in how much you have to pay and how easy it is to get the services you need. Although no plan will pay for all the costs associated with your medical care, some plans will cover more than others.

With any health plan you will pay a basic premium, usually monthly, to buy the health insurance coverage. In addition, there are often other payments you must make. These payments will vary by plan but essentially are deductibles and copayments.

Here's a list of key questions to consider in selecting the plan that best meets your needs:

• How much will it cost me on a monthly basis?
• Are there deductibles I must pay before the insurance begins to help cover my costs? After I have met the deductible, what part of my costs are paid by the plan?
• What doctors, hospitals, and other medical providers are part of the plan? Are there enough of the kinds of doctors I want to see?
• Where will I go for care? Are these places near where I work or live?
• If I use doctors outside a plan's network, how much more will I pay to get care?
• Are there any limits to how much I must pay in case of major illness? What about limits and deductibles for certain types of care such as surgery or maternity?

What is a co-payment?
A copayment is a fixed dollar amount or a percentage that you pay for each doctor visit/service. For example, with some plans you may pay a fixed amount such as $25 or $30 per visit. Other plans will charge you a percentage of the total fee for the visit. So if your copayment is 10% and the doctor visit was $200, you would pay 10% which, in this case, would be $20.

What is a deductible?
A deductible is the amount of annual medical expenses that a health plan member must pay before the plan will begin to cover expenses. For example, if your plan has a $500 deductible, you will pay the first $500 of your medical expenses before your health plan begins paying the expenses. Only expenses for covered services apply towards the deductible. For example, if you paid $100 for a visit to a chiropractor but the plan does not consider chiropractic care a covered expense, then the $100 will not apply toward your annual deductible.

What is the difference between an in-network and an out-of-network medical provider?
An in-network medical provider is within the approved network of providers for a particular health plan. Out-of-network providers are not on the list. If you visit a doctor within the network, the amount you will be responsible for paying will be less than if you go to an out-of-network doctor. In many cases, the insurance company will not pay anything for services you receive from outside their network; however, there are exceptions to this.

Can I buy health insurance for less if I buy directly from the insurance company?
No. Insurance companies charge the same premium whether the plan is purchased directly from the company, through a broker, or online through BestHealthPrice.com.

What do you mean by "best price?"
For the plans presented here we can provide the lowest price available anywhere.

What is a PPO?
A PPO is a Preferred Provider Organization. As a member of a PPO, you can use the doctors and hospitals within the PPO network or go outside of the network for care. You do not need a referral to see a specialist.

• If you obtain care from a medical provider outside of the PPO network, you will pay more for the service. For example, a PPO might pay 90 percent of the cost for a visit with an in-network doctor but only 70 percent of the cost for a visit to a non-network doctor.
• You will typically pay a copayment for each visit/service. These copayments are typically higher than an HMO copayment but not always.
• You will usually be responsible for paying an annual deductible.

What is an HSA?
"HSA" stands for "Health Savings Account," and Health Savings Accounts are great news for Americans!
The U.S. Congress recently passed legislation which makes paying for medical expenses much more affordable for consumers. As of January 1, 2004, the new law provides broad access to Health Savings Accounts, which allow consumers to pay for qualified medical expenses with pre-tax dollars (income-tax free!) and save for retirement on a tax-deferred basis.
An HSA is tax-favored savings account that is used in conjunction with a high-deductible HSA-eligible health insurance plan to make healthcare more affordable and to save for retirement.