You’ve Got Health Insurance Questions, We’ve Got the Answers (& the Deals!)

Health insurance is complicated, and sometimes searching for a plan can leave you with a lot more questions than answers. Purchasing a health insurance plan is a huge investment, so you need to make sure that you ask your agent the right questions before you spend your hard-earned money. EZ.Insure wants to make the process easier for you, so we have answered some of your most common health insurance-related questions.

How Much Does It Cost?

costs with arrows pointing outwards all around word written on a blackboard.
There are many different costs to consider when purchasing a health insurance plan.

This is one of the hardest questions to answer, because the amount you spend on healthcare will depend on your:

  • PremiumsWhen you purchase a health insurance plan this is the first bill that you’re going to get. It’s the amount that you pay every month to stay covered and keep your health insurance. This amount is calculated based on your age, tobacco use, plan type, and number of dependents covered. 
  • Copays– This is a set fee that you have to pay when you see a doctor or specialist. Depending on your plan, you will have different copays for doctor visits, specialist visits, and prescriptions.
  • Deductible- This is the amount  that you have to pay for covered services before your health insurance begins to pay. For example, if you have a deductible of $1,000, and you have surgery that costs $10,000,  you will have to pay your $1,000 deductible and then your health insurance plan will begin to pay their share.
  • CoinsuranceThe percentage of allowed charges for covered services that you have to pay. For example, some plans will cover 80% of the costs of services, and you will have to pay the other 20% after you meet your deductible. In the example above, if you had an 80/20 plan, you would pay 20% of the remaining $9,000, or $1,800. 
  • Out-of-pocket maximum– This is the maximum amount of money that you have to pay for covered services during a benefit period, which is usually a calendar year. So, in the example above, you would have spent $2,800 on your surgery – if your plan has an out-of-pocket maximum of $5,000, then you would be more than halfway to meeting your maximum. If you spent $2,200 more on healthcare costs in the course of that year, your insurance plan would begin paying 100% of your costs. 

This is a lot to take in, but EZ’s highly-trained agents can help you balance your  financial needs and health needs, and find you an affordable, quality plan. They will go over each and every one of these costs in all available plans, and will even help you find discounts and subsidies that can help you pay for your health insurance.

What Type Of Plan Do I Need?person's feet with 3 arrows in front f them pointing in different directions

Determining which plan coverage is right for you depends on your health and your financial situation. When it comes to ACA plans, there are four main categories, or metal tiers: Platinum, Gold, Silver, and Bronze. These categories basically determine the ratio of your premium to your deductible. If you want to keep your monthly premium bill low (but have a higher deductible), then a Bronze or Silver plan is best for you. But if you have some serious health conditions that require treatment, prescriptions, tests, or surgery, then a Gold or Platinum plan with a low deductible (and higher premium) is a better choice to keep your out-of-pocket costs down.

The most common types of plans are what is known as managed care plans, including PPOs and HMOs. PPOs have a more flexible network of providers that are considered in-network, while HMO plans require that you choose a primary care physician and get referrals for in-network specialists.

Is My Primary Care Doctor Covered?

If you’ve been going to the same doctor for years, then it’s only natural to want to make sure that you can continue to see them. So, when searching for a plan, you need to check that your primary care doctor is in the network covered by your plan. If you do go to any doctors that are out of your health insurance plan’s network, you will end up paying for the visit out-of- pocket, and that can be very expensive.

Our agents will make sure that your primary care physician is covered in the plan that you choose. We will go over all the plans within your area within minutes and search for your physician in each of these plans to make sure they are part of the network. 

What Happens In Case Of An Emergency?illustration of ambulance speeding

Accidents happen, life is full of uncertainty, and in the event that you need to go to the hospital, you want to make sure that you are covered. Some plans will require you to contact your primary care physician within 24 hours of an emergency room visit in order for your expenses to be covered. If that seems like it is too much to remember during an emergency, then we can find you a plan that does not have this requirement.

Are There Any Perks?

Some health insurance plans do include perks, such as free gym memberships. Some offer discounts for people who are on the right track to getting healthier, and many allow you to see your doctor virtually with telemedicine. That’s right, feeling under the weather? Call your doctor and get your prescription medication sent to your pharmacy without having to go see them in person. No waits, no headaches, just the ability to talk to your doctor or see your doctor, in the comfort of your own home.

illustration of two people with headsets on with the word support over them
Make sure that the health insurance company that you choose has excellent customer service.

Who Do I Call When I Need Help?

You should also make sure that the health insurance company that you choose has excellent customer service. All too often, people call their health insurance company and either get the run-around, get the wrong answers, or hang up leaving more confused than when they called. This can be especially frustrating when you’ve received a large bill in the mail and have no idea why you received it. EZ understands this frustration, which is why our agents work with the top-rated health insurance companies in the nation. We will find you a health insurance plan with a  company that has a proven track record of great customer service, and that will be ready, willing, and able to answer all of your questions. 

We understand that health insurance is complicated and confusing. That is why we have agents ready to help search and compare plans from top-rated companies across the nation, for free. Our main goal is to help you find great health insurance that is affordable and that meets your health care needs. To compare quotes within minutes, simply enter your zip code in the bar above or to speak to one of our licensed agents, call 888-350-1890.

About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

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