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Health Insurance in Oakwood Hills, IL

Your health is an integral part of your quality of life and also plays a critical role in the stability and prosperity of your future. However, maintaining your health can be complicated and may require significant financial planning. Fortunately, an adequate health insurance plan can help ensure you are able to access essential preventive and medical services.

How Does Health Insurance Work?a woman in a white shirt holding a stethoscope

Health insurance can be a complex and even confusing subject. Although the details of your coverage may vary significantly depending on your unique circumstances, understanding how the following components of policies function can help you ensure that your insurance is appropriate for your needs:

  • Premium—This is the regular amount you pay to maintain your health insurance.
  • Deductibles—This establishes a minimum amount you must pay out of pocket in addition to your premium before your coverage will begin to contribute financial assistance.
  • Copayments and coinsurance—These parts of your policy are flat fees and percentages, respectively, that are responsible for at the time of receiving specific services.
  • Out-of-pocket maximum—This clause establishes a limit to the amount that you can be required to pay out of pocket in a given plan year.

What Are Common Types of Health Insurance Plans?

Health insurance may come in many forms. Understanding the following standard options may help you determine what plan is right for you:

  • Health maintenance organization (HMO)—Under these policies, you select a primary care physician responsible for managing your general health and making any referrals for specialist care. Your HMO typically establishes a specific network of providers and services that will be covered, meaning you may have less flexibility when seeking care in exchange for lower costs.
  • Preferred provider organization (PPO)—These arrangements may offer coverage for more out-of-network services than HMOs, although providers within a PPO’s network will typically be covered at a higher rate. As such, these plans generally provide greater flexibility when seeking health care but will also likely have higher premiums and deductibles.
  • Point of service (POS)—These plans are somewhat of a hybrid between HMOs and PPOs. When you have a POS, you will be tasked with selecting a primary care physician; however, you may have greater freedom to seek medical services from out-of-network providers, albeit at a greater cost.
  • Exclusive provider organization (EPO)—This form of health insurance also generally combines elements of HMOs and PPOs, limiting coverage to in-network providers but not mandating you to establish a primary care physician or requiring you to have referrals in order to visit specialists.

Where to Get Health Insurance

When seeking health insurance, your options may vary depending on your unique circumstances. Many people may be able to acquire coverage through their employers, which can often provide cost-effective coverage that may also be available to spouses and children. For others, the Health Insurance Marketplace offers many options and coverage may also be available through government-sponsored programs (e.g., Medicare and Medicaid) and private insurance companies.

At Smith & Associates Inc, our dedicated team has over 25 years of experience helping families and individuals understand and secure appropriate health plans. Contact us today to get started.

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