So you need to find health insurance…

You may not be thrilled, you may even feel a little lost, but that’s okay. . .

We’ll guide you through everything…

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Take a look, we will help explain your options:Group InsuranceManaged Care PlansCOBRA Indemnity PlansHealth Maintenance Organizations (HMOs)Preferred Provider Organizations (PPOs)Short-Term Health InsuranceHigh Deductible Health Plans (HDHPs)

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So let’s get started!But first things first…

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Health insurance usually comes from one of twoplaces:

Full-Time Employers A Family Member’s Group Plan

…So what does this mean?

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You can lose health insurance if: You lose your full-time job. Your hours are reduced from full-time to part time. If your family member lost the Group Plan you

were carried under. You no longer qualify for your family member’s

Group Plan

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Lost your insurance?

Research your optionsTalk to your previous carrierSearch online at HealthCompare.org

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What about COBRA? (Consolidated Omnibus Budget Reconciliation Act)

It allows for an extension of coverage through your previous Group Health Plan for a specified length of time.

WARNING: The premium is usually higher than if you sought insurance on your own.

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It may cost you more than you’re ready to spend.

Ask your former Health Care Provider about any premium increase.

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Indemnity Health Care Plans

Managed Health Care Plans

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Indemnity plans have a greater flexibility when itcomes to picking doctors, hospitals, or other healthcare providers.

But flexibility comes with a price…

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The PRICE of Indemnity Plans:

You will probably have to pay an annual deductible before the benefits of the insurance kick-in. And, after that, there may be a discrepancy between what your providers charge you for their services and what your insurance opts to pay.

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Let's say your doctor charges $200.00 for an office visit. The insurance company has determined that $150.00 is a usual, customary, and reasonable charge.

Your insurance company then pays 80% of that amount (which would be $120.00).

You will still owe the doctor $80.00, which is the difference between the amount he or she charges ($200.00) and the amount paid by the insurance ($120.00).

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But what if you’d like tosacrifice that flexibilitywith providers for moreconsistent coverage?

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What are Managed Care Plans?They consist of a network of doctors and hospitals, or “providers.” You must choose among the providers in their network.

You can only receive the benefits of the discounts negotiated with specific doctor, hospitals, and health care providers in their network.

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HMOs: Health Maintenance Organizations

PPOs: Preferred Provider Organizations

POS: Point of Service Plans

We’ll focus on the first two…

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HMO (Health Maintenance Organization) Insurance company determines care

provider May be limited with coverage area or

available doctors Limited number of specialists Typically limited care options

PPO (Preferred Provider Organization) You determine care provider Typically national coverage Options for any specialist Options for best available care

==

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HMO

P

O

P

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They often require you to see a provider within the network and to obtain referrals from a primary care physician.

These restrictions help to control costs.

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If you decide that an HMO is the right plan for you, don’t forget to keep asking questions.

HealthCompare helps you to compare similar plans to find the perfect one for you.

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How do I determine which doctors are accepting new patients?

Can I change doctors? How are referrals handled if I need care from a specialist? How is emergency care handled? What services are covered, including preventive care? What if I need services not provided by the HMO network? Are there additional fees or co-payments required for office

visits, emergency care or other services and, if so, how much are they?

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So that’s an HMO…..

What about a PPO?

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• PPOs do not necessarily require that you choose a primary care physician to supervise and make decisions for your health care.

• In addition, with a PPO, you may be able to access providers and services outside of the “preferred” provider network

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IMPORTANT: PPO plans will likely involve more out of pocket costs than an HMO.

They typically involve deductibles, co-payments, and co-insurance amounts

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The increased financial responsibility with a PPO is a trade-off for the higher level or flexibility that you have in choosing a provider and accessing care.

This means you can select more providers, but it might cost you.

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So when selecting your doctors. . .

What should you ask?

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• How many are in the network?

• Who are they and where are they located?

• What are the processes and restrictions for referral to specialists?

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• What hospitals are available through the plan?

• Where is the nearest one in the network?

• How is emergency care handled?

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• What services are covered? • What are the deductible, co-pay and co-insurance amounts?• What is the out-of-pocket maximum? • What are the co-insurance amounts for non-preferred or out

of network providers? • Are there per-visit fees or other types of co-pays for in-

network services? • What is the cost difference between using in-network and

out-of-network doctors, and what costs are associated with care outside of the PPO?

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Which brings us to our last two plans:

Short-term Health InsuranceHigh Deductible Health Plans

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Short-term major medical insuranceis temporary health insurance thatoffers gap coverage to guard againsthigh costs of emergency medicalbills.

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Who should consider Short-term Insurance? Employees who are on extended leaves of absence. Recent graduates who are between parental and employer coverage. Employees who have been laid off or former employees between

jobs. New employees who are not yet eligible for the employer’s group

coverage. Early retirees. People who leave a group policy and want an alternative to COBRA.

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High Deductible policies require a higher deductible than most health plans, typically at least $1,000 for single insurance coverage and $2,000 for family coverage.

High deductible plans generally have lower monthly premiums than more comprehensive health plans.

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• When comparing high deductible plans (HDHP) costs with the costs of other plans, consider the potential premium costs relative to your potential health spending for the coming year to determine which plan works best for you and your family.

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It’s important to make an educated guess on what kind of medical assistance you might need in the foreseeable future.

This isn’t just true with just HDHP . . .

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. . .but with ALL Health Plans.

YOU

Who is HealthCompare:HealthCompare is your online one-stop-shop for health insurance where you can research and compare plans online from over 150 national carriers.

We Promise: To give you the best results for YOU, we never promote one carrier

over the other. We just assess your needs and show you the best options from national carriers with plans in your area.

Our Commitment is to YOU: As a division of The Word & Brown Company who has been the

leading source for small group health insurance for over 20 years, we have leveraged technology to build an easy-to-use research tool, supported by a world class customer service team.

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OurPromise

#1

1. You can enter your information

anonymously

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2. You can review your plan options

online in seconds

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3. You can even compare

plans side-by-side

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4. Then, you can apply online or call one of our

trained Benefits Advisors for help!

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Call toll free 877-641-1101

to speak to a trained Benefits Advisor

or…Go to HealthCompare.org today!

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