How to Compare Health Insurance: The Complete Guide
A lot of thought goes into choosing a health insurance plan and you may find yourself riddled with questions. How much coverage do I need? What can I afford? Do I qualify for a federal health care subsidy? But perhaps the biggest question is: How do I know which options work best for me and my family?
If you don’t have private health insurance from your employer, you can obtain coverage directly from an insurer, through a private exchange or using a government marketplace.
But unlike an employer’s plan, where all but a few choices are already made for you, choosing your own plan — public or private — means you’ll have to go out and compare all health insurance plans on your own. That means doing your homework on plan types, benefits, costs and providers.
This guide can help you figure out the best way to compare health insurance policies and which tools can aid you in making that decision.
A Look into Federal Health Care Coverage
If you don’t qualify for Medicare or Medicaid, you may be eligible for health care subsidies through the Affordable Care Act. The ACA provides financial assistance to individuals who can’t afford private coverage on their own or don’t have a plan through their employer.
You can visit the federal government website HealthCare.gov to find out whether you qualify for a subsidy. If you do, you can purchase a subsidy-eligible health plan through your state’s public marketplace if one is available, the federal marketplace, through a broker, or directly from an insurer. In any case, you can compare health insurance plans online.
Some States Have Their Own Marketplaces
Most states rely on the federal marketplace for residents seeking subsidized coverage. This is where you can explore various health insurance market options and compare 2021 health insurance plans. You would use the federal government site to compare health insurance rates and marketplace plans in states including Florida, Michigan, New Jersey, Texas, Virginia and Utah, to name a few.
But in addition to this marketplace, several states have created their own health insurance exchanges to help their residents obtain coverage. If you want to compare individual health insurance plans and rates in California, for example, you would use California’s marketplace site, Covered California.
It’s worth noting there are no municipal level marketplaces though. A resident of New York City, for instance, would rely on the New York State health marketplace to compare the market’s health insurance options.
Here is a list of where to compare health insurance plans if your state has its own marketplace:
- California: Covered California
- Colorado: Connect for Health Colorado
- Connecticut: Access Health CT
- Delaware: Choose Health Delaware
- District of Columbia: DC Health Link
- Hawaii: Hawaii Health Connector
- Idaho: Your Health Idaho
- Kentucky: Kynect: Kentucky Healthcare Connection
- Maryland: Maryland Health Connection
- Massachusetts: Massachusetts Health Connector
- Minnesota: MNSure
- Nevada: Nevada Health Link
- New Mexico: BeWellNM
- New York: New York State of Health
- Rhode Island: HealthSource RI
- Vermont: Vermont Health Connect (VHC)
- Washington: Washington Healthplanfinder
- West Virginia: West Virginia Health Insurance Marketplace
Business Healthcare Plans with Federal Subsidies
Small employers in participating states may qualify to purchase Small Business Health Option Program (SHOP) plans, which offer federally subsidized group coverage through the ACA. You can explore these business health insurance options and eligibility and compare rates online by using HealthCare.gov as a starting point.
The caveat here is that some states no longer offer SHOP plans. So, whereas a small business owner would have access to public and private health insurance options in Washington state, a business owner in Texas would not have those same options since the state does not participate in SHOP.
How to Compare Health Insurance Plans Online
Not too long ago, the only way to compare your health insurance options was to make a lot of phone calls, waste a lot of paper and lose a lot of valuable time. Fortunately, one of the luxuries of living in the digital age is being able to compare health insurance quotes online. Finding a reliable website will allow you to compare health insurance quotes easily and within minutes.
That’s what we do at insuranceQuotes. We strive to be the best health insurance comparison website
by providing multiple free quotes from national health insurance providers and local companies all in one place.
You can compare health insurance rates by ZIP code to quickly and easily find the plan that best suits your individual or family needs.
What Are the Different Types of Health Insurance?
Should you get an HMO or a PPO? Or would you be better off with an EPO or a POS? Understanding the differences between the types of health insurance plans that exist is essential when comparing policies.
To make sense of the acronyms, here’s a breakdown:
A Health Maintenance Organization offers lower out-of-pocket costs and fixed premiums and is one of the least expensive health care options. The tradeoff is that you must stick with in-network doctors, and there are fewer providers to choose from.
With a Preferred Provider Organization, you will pay higher premiums than you would with an HMO, but you have the freedom to see out-of-network doctors and specialists without needing a referral. Copays are lower for in-network doctors.
An Exclusive Provider Organization provides in-network coverage only, except for in emergencies, but you have a much larger network to work with. Premiums are moderate, and out-of-pocket costs are on the lower end, too.
With a Point of Service plan, you can see out-of-network doctors by paying premiums slightly higher than what you would pay with an HMO. Copays are lower for in-network doctors.
Your Healthcare Needs Will Help You Choose the Best Health Insurance
Different plans cover different needs. It’s not the same to compare health insurance plans for a family than it is for singles, for example. You may also need a plan with specific health insurance benefits, such as mental health care or rehabilitative services. Here are some things to consider:
If you have a family or are planning to start one, check to see how health insurance plans for family compare for pregnancy, pediatric care, prenatal care and the individual health needs of your family members. For older children, you may also investigate short-term plans for college student health insurance.
Even though senior citizens qualify for Medicare coverage after age 65, you may want to compare consider costs for extra health insurance when you compare health insurance plans for seniors. You can compare Medicare supplemental health insurance plans to pay for any remaining health care costs, such as copayments and deductibles.
Are you a jet setter or someone who takes a lot of business trips? If so, you might look for a plan that includes travel health insurance when you compare the market. This would provide medical and dental coverage in case you need care while you are traveling.
In Network vs. Out-of-Network
You’ll want to compare health insurance networks available for each plan type to see if your preferred doctors are in the plan’s network. If you see a lot of specialists or use multiple medical providers, you may want a plan that has out-of-network coverage or a broader network.
Comparing Annual and Out-of-Pocket Health Insurance Costs
When you sit down to compare health care insurance plans in hopes of finding affordable health insurance, one of the most important considerations is how much money you will need to pay on your own for health care, versus how much the insurance companies are willing to cover.
In addition to comparing your annual rates, which consist of the monthly health insurance premiums you pay for coverage, look closely at out-of-pocket expenses, which include:
Copays: These are the fixed prices you pay to see your medical providers — including doctors, specialists and emergency room visits — at the time of care.
Deductibles: A deductible is the amount you need to pay before your health insurance kicks in with the funds to cover the rest of your medical expenses.
Coinsurance: This is a percentage of a medical expense you will pay, with your health insurance covering the rest after you meet your deductible. So, if your health insurance policy indicates you have 25% coinsurance for medical procedures, that means you would pay 25% of the cost of the procedure. Your insurance would cover the other 75%.
Our Tips for How to Compare Health Insurance Plans
Although it may seem overwhelming to compare plans to find the best health insurance, there are ways to simplify your search. Here are a few things you can do to make the experience a breeze:
- Create a spreadsheet to compare health insurance quotes. Once you have all your quotes and the details on each plan’s benefits, providers and costs, plug it all into a spreadsheet so you can compare health insurance more easily. This can be one of the best ways how to compare two health insurance plans side by side to determine which agency and plan is the best fit.
- List your priorities: Another helpful way to compare two health insurance plans is to make a list of all your health care needs, including which doctors you see each year, how often you need to see them, what kinds of treatments you usually require, and how much you’ve budgeted for health care expenses.
- Let the internet do the work. Remember, you don’t have to spend hours on hold to gather the information you need to compare health insurance plans.
You can compare health insurance plans online whether you’re shopping for private coverage or government health care options such as ACA plans and Medicare supplements. Online tools like InsuranceQuotes, HealthCare.gov and state marketplaces can take the pain out of the process.