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3 Things to Know About Health Insurance

Learn more about some of the finer details behind your coverage.

Whether you're a shopping for your first health insurance policy or simple learning more about the industry, understanding the logistics of health insurance is an important first step in understanding your coverage and ensuring that you're prepared when the time comes to use it.

Our team at Lowry has researched a bundle of three important factors to consider to get you started off on the right foot in the world of health insurance.

4 Health Insurance Categories

The term "health insurance" is one blanket term that covers a wide variety of different plans that exist to help each customer choose a policy that is best fit for their needs. At its core, health insurance is comprised of four different "metals," varying by the total cost paid by each party - the insurance company and the policyholder.

  • The Bronze category features the lowest monthly premium but brings the highest deductible cost if you have a medical expense that has to be taken care of.
  • The Silver category provides a medium-grade option, bringing both a moderate monthly premium and a moderate cost.
  • The Gold category brings a higher monthly cost, but a lower cost when you need care.
  • The Platinum category brings the highest monthly premium out of all other plans, but brings the lowest cost when you actually enact your policy.
Medical Checkup

While each policyholder must decide on a coverage tier that is right for their needs, the choice can come down to how often you require medical care. If you're someone who frequents doctor's offices and faces an abundance of medical challenges, Platinum-grade coverage is likely a good investment for you. However, for those that don't often need medical care, a lower monthly premium may be a more financially wise decision.

The True Cost of Health Insurance

Health insurance isn't just a matter of paying a bill every month for comprehensive coverage. While your monthly premium is the upfront cost of insurance, it's important to take your deductible into consideration when planning for a medical procedure. Your deductible when the time comes to pay for a procedure can be much more expensive than the monthly premium that you've become accustomed to paying depending on the type of plan that you have.

Calculating Health Costs

There are also out-of-network costs to consider, bringing an additional charge to visit doctors and specialists who are not "in your network" - those who have negotiated a fee with your insurance provider.

Finally, your out-of-pocket maximum is a cap on the amount that you have to spend on healthcare in a given year before your insurance provider begins covering the entirety of the cost. While out-of-network costs and the premiums themselves don't count toward your out-of-pocket maximum, this is still an important metric to track to ensure that you're actively monitoring all aspects of the cost of your health insurance..

Know Your Insurance Network

Depending on your policy and your provider, you may be limited to a specific group of doctors, specialists, and organizations that are within your network except in the case of an emergency. There are four main types of health insurance plans in today's market: EPO, HMO, POS, and PPO.

While these are all important elements to consider when it comes to health insurance, it's important to consult a reliable insurance professional to talk through your goals and needs to find a health insurance solution that is right for you. Lowry Insurance's team of professionals has decades of experience pairing people with a policy that is right for them, providing insurance coverage that they can count on in their daily life.

Interested in learning how we can improve your policy? Let's talk.