How Can You Get Healthcare If Your Employer Doesn’t Cover It?
It’s a common complaint: employers either dropping health benefits or not offering them to new employees. How can you find coverage if your employer doesn’t offer it?
There are several options and unfortunately you’ll have to be willing to do more research, spend more money and potentially have worse coverage than if you were insured by your employer. But all is not lost.
Shop around and compare rates. Do it online to save you money and time. There are a lot of options available, tons of coverage choices and deductible ranges.
You might consider a health insurance broker, who already has a lot of the information you need on different insurers and can help you find what’s best for you. Try several brokers if need be. Some may have different favorite insurance companies than others, so it might behoove you to talk to a few people.
Consider a PPO (preferred provider organization), that will have lists of physicians to choose from to be your primary care doctor. If you stay within the PPO network of doctors, you pay a low copayment at the times of your visits. Out-of-network visits will cost you more in co-pay. You don’t need approval from the insurer to consult a specialist; PPO’s will offer you the most flexibility but generally cost more in monthly premiums and potentially more in personal expenses.
HMOs (health maintenance organizations) can have the most rules and restrictions, but are usually the cheapest options. You’ll need to see physicians within their network, but probably have no or little by way of co-pay. You most likely have to get approval from your HMO primary care physician before seeing a specialist.
Consider a fee-for-service plan. The biggest benefit is that you have total say in which physician you see and can make your own determinations as to whether you need a specialist. There is, however, a high out of pocket cost for this service and the premium will be higher. Plus, if your primary doctor charges more than deemed “customary,” you’ll have to pay additional for the overages.
Look into POS (point-of-service) networks, which operate a lot like PPO’s, except your primary doctor decides about which specialists you might need and when. You may still choose a doctor outside of the POS network, but prices go up.
Make sure you know if benefits you’re seeking will be limited for pre-existing conditions, and if there’s a waiting period before full coverage kicks in. Know that many insurers do not cover pre-existing conditions.
When shopping around, be sure to get all the details on dental, vision and prescription coverage. The coverage vary wildly, and it will be to your benefit to know beforehand exactly what you’re paying for. Look into the background of your chosen insurance company, as well. Are there a huge number of complaints about them? Do they make you wait for decisions about care or importantly, too, do they cover your expenses up-front or do you wait for reimbursement?
