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How to Buy Health Insurance Like a Pro

Oct 14, 2022
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Buying health insurance probably isn’t among the more exciting purchases you’ll ever make. But like it or not, it’s one of the most important each year. So, we want to help you get it right.

When you start shopping for health insurance, likely the first thing you’ll check is the price, or monthly premium. This makes sense, but just like buying a car or a house, price doesn’t tell the whole story.

You might think of the premium—the monthly charge for coverage—as a “sticker price.” But that’s only the beginning of what you’ll pay because most plans include co-pays, co-insurance and deductibles, which all add up to how much you pay out-of-pocket annually. You can learn more about those costs here.

It’s important to understand the benefits you’ll use because they directly impact how much you might pay to reach an annual maximum out-of-pocket limit, when insurance takes over and pays all your costs. Generally, the less you pay for insurance, the higher your deductible—and the more you’ll pay out-of-pocket as you use more services. So, knowing what you might need will help you limit out-of-pocket costs and maximize your benefits.

You’ll also want to understand types of coverage and be sure your carrier offers a comprehensive network. For example, an “HMO” which stands for health maintenance organization; gives you access to preferred providers; but you’ll need to stay in-network to get coverage. A second popular option, a “PPO,” or preferred provider organization, costs more but affords the freedom to use out-of-network providers at a slightly higher price.

Within each type of plan, deductible costs are designated by Bronze levels, which cost the least, and Silver, Gold and Platinum levels which cost more, but have lower deductibles. You can learn more about those levels here.

As you compare plans, you’ll get information about costs and coverages, but you’ll also see which plans offer services like wellness programs, dental or eye exams, or chronic care programs to support you along the way. Unique to Health Options, for example, is a care management program that partners with community services to support wellbeing, such as providing transportation to appointments or even meals for someone who is recovering at home.  

You might consider a Silver, Gold or Platinum plan if:

  • You have a chronic condition like asthma, diabetes, coronary artery disease or cancer
  • You have a planned surgery coming up
  • You frequently visit specialists or your primary care physician
  • You are planning to have a baby or have small children
  • You take expensive brand or specialty medications

You might consider a Bronze plan if:

  • You are healthy and take few medications
  • You rarely see a doctor

While costs can weigh heavily when selecting a plan, it’s most important to choose coverage that fits your needs. And you might find help paying for insurance thanks to the recent passage of the 2022 Inflation Reduction Act, which extended Affordable Care Act premium tax credits. To find out if you’re eligible, visit CoverME.gov, Maine’s online Health Insurance Marketplace. For information or to get help choosing a plan, you can also call Member Services at (855) 624-6463.

SEE ALSO

As part of an effort to expand access to free and accessible world-class fitness in beautiful public spaces, Community Health Options has partnered with National Fitness Campaign (NFC) to build Fitness Courts® across Maine.

The Fitness Court is an outdoor bodyweight circuit training gym that supports all-level workouts and can be completed in as little as seven minutes a day. The Fitness Courts are free to use, designed for all fitness abilities, and suitable for ages 14 and older. With the free Fitness Court app, available for iOS or Android, users can take classes, learn workout routines, and get fit.

The ultimate goal is to fight back against preventable diseases caused by sedentary behavior and transform the next decade so that millions of Americans will choose outdoor wellness activities for healthier lives.

“Mainers are known for enjoying the great outdoors. Our partnership with the NFC will help more adult Mainers enjoy exercising outside and will allow them to be their healthiest selves, mentally and physically,” said Kevin Lewis, president and CEO of Health Options. “Our vision to be a leader in transforming and improving individual and community health naturally aligns with the NFC’s work.”

Through the NFC partnership, grant-funded Health Options Fitness Courts will be constructed in easily accessible public spaces beginning in Summer 2022. The NFC and Health Options will begin accepting grant funding applications on November 4, 2021, to support Fitness Court construction in local communities.

Qualified municipalities, schools, and other organizations who own accessible public space are encouraged to apply here: nationalfitnesscampaign.com/maine. Grant recipients will receive a wellness toolkit and design resources to aid in planning, funding, and launching their outdoor Fitness Court and community wellness campaign. To learn more about National Fitness Campaign and how to qualify for funding, visit: nationalfitnesscampaign.com/maine.

Watch this video to learn more.