Comparing Policies

Besides the differences in state mandates, in premiums to be paid, and in yearly deductibles to be met, there are many other ways that health insurance policies can differ. You should consider the following factors when comparing policies:

• Maximum lifetime benefit. The higher, the better. Some policies have unlimited benefits, while others provide limits (such as $250,000, $500,000 or $1,000,000) on the total amount of benefits that will be paid in a lifetime.
• Co-payment. The co-payment amount is the percentage of covered expenses that you must pay. If the policy provides for a 10 percent co-payment, you will be reimbursed for 90 percent of your covered expenses; if it provides for a 20 percent co-payment, you will be reimbursed for 80 percent of your covered expenses.
• Limitation on yearly per-person outlay. This represents the maximum amount of unreimbursed expenses (such as $2,000) that you would have to pay for each covered individual in any one year. It includes the amount of your deductible, and a portion of the co-payments made by you during the year.
• Coverage for type of care. Policies often apply different co-payment amounts and length-of-stay limits to the following: hospital rooms and doctor fees, surgical procedures, dental procedures, mental health services and out-patient care.

Keeping in mind all the components mentioned above, here's a menu of health coverage plans you'll have to choose among:

• Fee-for-Service (Indemnity) Health Insurance
• Preferred Provider Organizations (PPOs)
• Health Maintenance Organizations (HMOs)
• Major Medical (Catastrophic) Insurance
• Dental Insurance
• Vision Insurance
• Health Savings Accounts (HSAs,)Medical Savings Accounts (MSAs), and Flexible Spending Accounts (FSAs)
• Medicare/Medicaid
• Long-Term Care Insurance