According to the Centers for Medicare and Medicaid Services (CMS), the average annual cost of healthcare per person in America is at least $11,000. For most Americans, this is such a considerable amount, meaning it can potentially send you into financial turmoil, especially if you have no health insurance coverage. Luckily, health insurance policies come in to cover healthcare costs at a more affordable rate. For this reason, you should purchase the right health insurance for yourself and your family to avoid the burden of paying out of pocket.

Here are some of the important health insurance questions you should ask to make the best decision.

What Type of Health Insurance Plan Is It?

As per the federal government website, the four types of health insurance plans available in the U.S. today include:

  • Exclusive Provider Organization (EPO) – This insurance plan provides coverage when you seek healthcare services from professionals or providers within a specific network, except in emergency cases.
  • Health Maintenance Organization (HMO) – This is a plan that HMO offers to Americans to cover medical costs from healthcare professionals and hospitals that have a contract with them.
  • Point of Service (POS) – This plan allows you to seek health care services from health practitioners and hospitals within a particular network at lower costs. It also allows out-of-network coverage at higher costs.
  • Preferred Provider Organization (PPO) – Here, you can access healthcare services outside the network and consult a specialist without a referral from your primary doctor. Nevertheless, this plan is pricier than the rest.

How Much Does the Plan Cost?

Currently, the average monthly cost of health insurance in the U.S. is $456 per person, and this may vary depending on the type of health plan, according to eHealth Insurance. Other factors that determine health insurance costs include the amount of coverage, health condition, age, and lifestyle habits. For instance, a smoker will pay higher health insurance costs than a non-smoker, says the National Center for Biotechnology Information (NCBI). Therefore, the cost of health insurance should be among the first health insurance queries you ask before purchasing to plan your budget.

What Are the Health Insurance Plan Exclusions?

Depending on the type of health insurance policy you purchase, there may be some exclusions. For instance, most health insurance policies do not cover elective cosmetic procedures, fertility treatments, and beauty treatments. Additionally, while your policy may cover the basic healthcare procedures such as prescription drugs, doctor visits, and wellness care, there may be exclusions on those basic aspects depending on the amount of coverage you have. Although the Affordable Care Act forbids insurance carriers from charging excessive amounts or denying coverage for people with pre-existing conditions, some insurance companies still violate this act, as reported by the U.S. Department of Health and Human Services (HHS). Therefore, knowing the exclusions will enable you to choose a plan that favors you.
When buying health insurance coverage, you should ask your insurance agent these questions. Do you need help with your health insurance coverage? If so, then contact the experts at Randy Jones Insurance Services in Pleasanton, California today.