Trying to understand health insurance is a process that tends to leave people sick.
With different benefit packages luring workers to ? and from ? employers, understanding the inner workings of health plans is becoming more and more important. Maybe, under your new plan, a family doctor isn?t covered, or a prescription drug you take regularly isn?t on the list of approved medications.
When picking a plan, smart consumers must pay attention not only to the small print but also to the details that come with it.
“Many employees, when they go to select a plan, want to make sure their doctor is included,” said Robert Cohen, a managing partner with Alliance Benefits & Compensation LLC. “Then they look at cost as it relates to the benefits being offered. They also go through factors like coverage, opt-out choices and specialist referrals.”
National health care expenditures are currently more than $1.6 trillion, the latest report by the Maryland Health Study Commission indicated.
Current data points to Marylanders spending more than $8.6 billion for inpatient and outpatient hospital care yearly. Add to that $4.9 billion for physician services, $3.6 billion for other professional services and nearly $3.5 billion in prescription drugs.
For employees in Maryland, the yearly average cost of employment-based health insurance is about $3,200 for an individual and more than $8,800 for a family.
“If you want to save money and you don?t care how the health care is delivered, you look at the [Health Maintenance Organization],” said Drew Tignanelli, president of The Financial Consulate in Lutherville. “If you want the greatest flexibility you go with the point-of-service plan, but that is the plan that could also give you the biggest gap in how much you have to put up. And if you want the best of the two worlds, you go with the preferred provider.”
A point-of-service plan typically entails being able to use an in-network or out-of-network provider, while a preferred provider plan utilizes a more limited network of places to go for treatment.
More information
» www.ahrq.gov
» www.consumersunion.org/health
» www.iii.org
