Choosing a health plan
The best plan for you depends on your individual needs. We'll walk you through the different types of plans and important things to consider when making your choice.
Where to get health insurance
There are two ways you can get insurance. Let's take a look.
Employer-sponsored plans
Many employers work with health plans to design one or more plan options they can offer to employees. Under these plans, employers share the costs of health insurance with their employees. If you have access to a health plan through your employer, it typically means you'll have lower premiums, access to larger provider networks, and additional perks. Generally, employer-sponsored plans will cost you significantly less.
Planes individuales
You can buy individual health insurance through private insurers or through the Health Insurance Marketplace. They're typically more expensive since you don't share the cost with an employer. However, you're not restricted to an employer's selection of plans and can choose one you want based on your budget and needs.
For illustrative purposes only
Types of health plans
There are different plan types to help ensure everyone’s health care needs can be met. Here are three common types you’ll see in the marketplace. We also offer supplemental Medicare plans for seniors who want additional coverage. Learn more about Medicare here.
HMO (health maintenance organization) plans usually have lower premiums. You're required to choose a primary care provider (PCP) and share your selection with your health plan. You'll visit them first when you need care. You'll need a referral from your PCP to see a specialist and care is only covered when you stay in your health plan's network.
PPO (preferred provider organization) plans generally have higher premiums and out-of-pocket costs, but offer more flexibility with the option to get care out of network. You won't need a referral to see a specialist either.
High-deductible health plans (HDHP) have lower premiums but high deductibles, so you pay more out of pocket before insurance takes care of the full cost. They often come with health savings accounts (HSA) so you can put tax-free money toward your costs.
What to consider when choosing a plan
The plan you choose depends on a lot of things, from your life stage to your expected care needs. And if you're getting insurance through your employer, you'll have to choose from the plans they offer. Here are a few things to think about when you make your decision.
Costo
Look beyond monthly premiums and factor in likely out-of-pocket costs, like copays and deductibles. Think about what you may have coming up in the next year, like specialty care needs or pregnancy.
Red
Some plans require referrals and only cover in-network care. Make sure your providers are covered in the plan's network.
Comodidad
It helps to have plenty of in-network providers who can meet you where you are, available either in person or for virtual care.
Extras
Do you need additional coverage for vision and dental? Or, if you like to stay in shape, a plan with wellness benefits and fitness incentives might be a good choice.
Still stuck? Team blue is here.
Our Team Blue Member Service advocates are ready when you have questions about your coverage, benefits, finding care, and more. They'll help you make sense of it all.