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You cannot go anywhere these days where health insurance somehow does not make its way into a conversation or discussion regarding politics, budgets, family, or business. With Obamacare remaining at the forefront of national policy debates, many people are uncertain as to what their health insurance future and costs will look like.

Well, until that is finally settled, here is a brief primer on how to shop for the many types of health insurances available, and how to make the right choice for you and your family.

Health Insurance Questions You Must Ask First

To identify the right health insurance coverage for you as a single or for your family, the following questions will help you determine the right plan to purchase.

  • Are you obese, a diabetic, have ongoing family history of cancer or other diseases, or plan on being pregnant a lot, or will need lots of tests and preventative health care?
  • What are your current family medical needs?
  • If you have a working spouse who has insurance through their company, how does your company’s compare, or, if unemployed, what is lacking in their coverage you want to be protected for?
  • If you switch insurers, will you risk losing your current doctors and pharmacists?
  • Have you compared costs between various plans to determine if one coverage meets needs at a better cost?
  • Have you considered a Health Savings Account? This is a great way to save money.
  • Have you considered insurance plans through work, an association, or a group of like people, such as religious affiliations, or home-based business networks?
  • Have you spoken with human resources to fully understand what options you have and at what cost? What does your employer cover? Know this before buying any additional insurance.
  • Are you aware of what Cobra provides once you have been let go from your job, and at what cost to you?


We hear these terms frequently when health insurance is discussed, but what exactly are they?

  • HMO – Stands for “health management organization.” Patients can see doctors who are part of this organization’s network. If you want to see a specific physician who is not in the network you will have to pay dearly to do so. You would choose one of the mmbersto be your primary care physician, and he would then refer you to other specialists within the network.
  • PPO –Stands for “preferred provider organization.” Also a network of doctors who have negotiated fixed costs for care, but this generally comes with a higher co-pay and related costs.

Low Deductible or High?

Many people choose the low premium that is paid monthly with a higher deductible to keep known costs down. This works well for those who are young or are in great shape. However, for those who may need more health care for the year may choose a lower deductible and pay a higher premium. Crunch the numbers to see for yourself which makes sense for you in the oming 12 months.

Basic Health Insurance Terms

Because there are so many variables when it comes to purchasing health insurance for yourself or your family in South Carolina, we will look at the many terms that surround health insurance so you are clear when on definitions when making a buying decision:

  • EPO – Exclusive Provider Organization. It is an HMO that is national instead of regional, like most.
  • Catastrophic Plan – Also known as a “safety net” plan, this comes with high deductibles but is perfect for those who do not get sick. The deductibles are high, but once you pass the threshold, say, after a serious accident, the rest of your care is covered at 100%.
  • Copay –Out-of-pocket co-payment’s are typically between $10-$75 depending on your plan, and often can be deducted from your deductible. You will pay this to the physician upon receiving care.
  • Deductible – Your deductible is the amount of money you have to pay before your insurance, with all of its benefits, kicks in. For example, if your deductible is $1000, the first grand must come out of your pocket before your insurance providers pays a penny. Each year you have to start over again.
  • HSA – Many people are choosing a “health savings account.” Most people know that your premium from work is pre-tax, but so is an HAS. There are limits to how much you can put in one, but having enough to cover your deductible only makes sense as it is also pre-tax form of savings. You can roll the money into the next year, as well, but you cannot use it for anything other than health care or your will be highly taxed.
  • Prescription Drugs Programs – Either your insurer will cover your prescription program or they will hire out a third party. Prices for a particular drug are fixed so it will not matter where you purchase them.

Now, armed with this information, go make the wisest, most affordable purchase of health care insurance you can.

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