Know which health plan is right for you?

With all the news of late regarding health care reform, do you know which health plan is right for you?

Hopefully you're not one of those individuals who think you can get away without health insurance, living on the edge and dodging this illness and that surgery.

Number of items to consider

When thinking about choosing an HMO, PPO or POS, keep in mind that there are a number of important items to consider when choosing the right plan for you.

Among the items to look at will be: services offered, choice of providers, costs, location, and quality of care.

As you break down the available options, there are some things to take into consideration.

First, what are the services offered by each plan?

You want to know what services are limited or not covered. See if there is a good match in what you need and what is offered. Look into if the plan offers the medicines and equipment you may require. Also research whether or not the plan determines what is or isn't experimental. See if there is recourse for you to challenge a plan's decision regarding medical care or coverage.

Secondly, what providers are available?

Be sure to determine which hospitals, doctors and other medical providers are tied to the plan. Check to see if there is an ample number of the type of doctors you want to see. Determine if in the event you need to see a specialist if you can refer yourself or your primary care doctor must do that.

Third, what can you expect to pay for health care?

Another important aspect of health care is how much it will cost. Make sure to clearly understand what your premium will be, if and when you have to meet a deductible, and how much the co-payment and/or co-insurance will cost. Many plans will have an out-of-pocket maximum. Should you apply enough money in medical costs to satisfy the maximum, the plan in turn pays 100 percent of your medical charges for the remainder of the year. If you are expecting large medical expenses, it is not a bad idea to locate a plan that has a low out-of-pocket maximum. Also see if the plan has a lifetime maximum. Most HMOs do not carry lifetime maximums, so if you figure on having major medical expenses, be sure to check the plan's lifetime maximum.

Also remember to look into what is the location you will need to visit for care?

Where you go for your care should be high on the importance lance when shopping for health insurance. Finding a place close to where you live or work is to your benefit. Also look into what happens if someone needs medical care in another state or is outside of the country when needing health care.

Finally, what is the quality of care I can expect?

While the quality is hard to measure, more information is becoming available on the Internet and elsewhere to help consumers become better aware of what is available to them.

Among the items to check is to see if the plan is accredited, meaning it has passed certain tests. You are best served by looking for accreditation by National Committee for Quality Assurance (NCQA) for HMOs and POS plans; American Accreditation HealthCare Commission/URAC for PPOs; and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for hospitals.