Health Insurance Options Explained: Making Informed Choices

Navigating health insurance is essential for your financial well-being. Here are five key points to help you make informed choices:

Types of Health Insurance Plans

HMO (Health Maintenance Organization): Requires choosing a primary care physician and getting referrals for specialists.

PPO (Preferred Provider Organization): Offers flexibility in choosing healthcare providers without referrals.

EPO (Exclusive Provider Organization): Limits coverage to in-network providers, without requiring referrals.

Costs and Premiums

Monthly Premiums: Fixed payments to maintain coverage.

Deductibles: The amount paid before your insurance starts covering costs.

Co-pays and Co-insurance: Your share of expenses for medical services and prescriptions.

Coverage for Medications and Treatments

Prescription Drugs: Check the formulary to see if your medications are covered.

Preventive Care: Screenings and vaccines at no additional cost.

Emergency Services: Coverage for urgent care and emergency visits.

Network of Providers

In-network vs. Out-of-network: In-network care costs less.

Specialist Access: Check if the specialists you need are covered.

Hospital Coverage: Ensure your preferred hospitals are included.

Additional Benefits

Telehealth Services: Convenient virtual consultations.

Wellness Programs: Incentives to encourage healthy habits.

Mental Health Services: Coverage for counseling and therapy.

Traditional Health Insurance Alternatives

Direct Primary Care ( DPC): you pay a monthly membership fee to cover your day to day medical needs, bloodwork, prescriptions, minor illnesses and sickness, etc. Usually no co-pays or deductibles, your membership fee covers these visits. This is similar to a primary care doctor in traditional insurance.

Your DPC is then paired with a Health and Medical Cost Sharing Community: each community members pays a monthly contribution ( similar to a premium) based on your age. The community funds are only shared and covered for major medical needs like surgeries, disease, major illnesses. With these plans you have an initial un shareable amount ( similar to a deductible ) that you choose. Any medical need less than the un shareable amount you pay out of pocket. When you have medical needs about your un shareable amount the Health and Medical Cost Sharing kicks in ( usually at 100%).

Both of these alternative are NOT Insurance and can have limitations for pre-existing conditions and may not be suitable for all people.

Choosing the right health insurance involves evaluating your needs and comparing costs and coverage. Making informed decisions will protect both your health and financial future.

Wela Financial Advisory doesn't offer or sell any health insurance plans, but we do evaluate health insurance policies for our clients and make recommendations. If you need any help or have questions, Let's Talk.

All the best,

Your Wela Financial Advisory Team

_{Brent Forrest & Associates, LLC. dba Wela Financial Advisory (Wela) is a registered investment adviser. The information presented is for educational purposes only. It should not be considered specific investment advice, does not take into consideration your specific situation, and does not intend to make an offer or solicitation for the sale or purchase of any securities or investment strategies. Investments involve risk and are not guaranteed. Be sure to consult with a qualified financial adviser and/or tax professional before implementing any strategy discussed herein. This article and images may have been enhanced by utilizing artificial intelligence (AI). Brent Forrest & Associates, LLC dba Wela Financial Advisory (Wela) is a registered investment adviser. The information presented is for educational purposes only and is not intended to make an offer or solicitation for the sale or purchase of any specific securities, investments, or investment strategies. Investments involve risk and, unless otherwise stated, are not guaranteed. Be sure to first consult with a qualified financial adviser and/or tax professional before implementing any strategy discussed herein. Past performance is not indicative of future performance. Wela may discuss and display, charts, graphs, formulas which are not intended to be used by themselves to determine which securities to buy or sell, or when to buy or sell them. Such charts and graphs offer limited information and should not be used on their own to make investment decisions.}