Health Insurance Quotes in Franklin, ME

Compare Health Insurance Plans in Franklin, ME

Health insurance is about as personal as it gets. It is one of the most intimate and particular types of insurance. Plans available in Franklin, ME vary in the type and the amount of coverage, as well as the amount of accompanying fees. Generally, plans with lower monthly payments (premiums) tend to have higher co-pays and minimum amount of money that the insured must pay before benefits become active (deductibles), and offer limited coverage. This means that the insured will be responsible for a larger portion of the total bill. Plans with higher monthly installments will have lower co-pays and deductibles and offer more complete coverage. The insurer assumes responsibility for a larger portion of the bottom line.

The primary step toward obtaining health insurance in Franklin, ME is to determine what the insured may need in the coming year, since the opportunity to adjust a policy comes at least once a year. History of behavior and health issues along with what will most probably happen in the near future must be reconciled in order to anticipate what care the insured may realistically need.

For example, if the insured is usually healthy and does not have pre-existing chronic ailments, then a good option would be a policy that covers preventive care visits and/or fairly reasonable premiums and deductible to accommodate visits to primary care facilities. If the insured travels regularly or spends a significant amount of time in harm's way, then a good policy for him or her would cover frequent ER visits and regular doctor visits. If the insured suffers from a chronic condition or disease, then a good policy for him or her would cover regular doctor visits along with preventive care and possible hospital visits and medication. Policies that focus primarily on catastrophic situations requiring emergency hospitalization have the least probable premiums. Let MyRatePlan help you find the best health insurance in Franklin, ME for your needs.

Different Types of Health Insurance Policies in Franklin, ME

Different health insurance options exist for people living in Franklin, ME and surrounding areas. Most of these plans offer similar coverage levels, but some plans are more flexible and convenient than others. The typical choices include the following: FSA, HMO, HRA, HSA, MSA, POS, and PPO. While this list is quite comprehensive, and the terms seem a little confusing, people need to understand the differences between them.

Health Maintenance Organization (HMO) focuses on the insured person having a primary care provider to coordinate all of their healthcare needs. In many ways, this doctor acts as a gatekeeper. For instances where a person needs to visit a specialist for one reason or another, they need to first go to their primary care doctor. A referral to visit another doctor is required before services from that other doctor are covered. In most cases, these services will not be covered without the referral, and sometimes the referral cannot be gained after treatment to take place retroactively. These plans have lower premiums, and there are limited options when picking a doctor. The pool to choose from is smaller as some providers will not accept HMO plans. The plus side to this plan type is the fact that deductibles do not take place, and the related out-of-pocket costs are minimal and rather reasonable.

Preferred Provider Organization (PPO) plans have a larger network of providers in Franklin, ME that participate in connection with it. As with HMO, a PPO plan requires the insured to pick a primary care doctor, but the list of options is much larger. As a bonus, a referral is not needed to visit a specialist, though people can opt to go for a referral anyway. Doctors and hospitals either belong to the network or they do not, and going with in-network options reduces the amount of out of pocket the insured has to pay. The opposite is true of doctors and hospitals who do not participate in the network. Most people decide to go with in-network options to save them money in the long run. This plan type operates with deductible and co-payments, and it also places limitations on how much is spent out of pocket each year.

The Point of Service (POS) plans fall in the middle between HMO and PPO. The network of doctors and hospitals offers a decent amount of choices, and so long as treatment options fall within these options, the insured does not have to pay any outrageous deductible or co-payment. On the other hand, going with an out of network option means paying much, much more.

These three types are the most common types of plans available to people in Franklin, ME, but there are some other, less conventional options. These options include a Flexible Spending Arrangement (FSA), Health Savings Account (HSA), and a Medical Savings Account (MSA). They all operate under the same circumstances where the insured or their employer pays into an account in a tax-exempt manner to cover treatments. Anything from doctors' appointments to medications can be covered under one of these plans. The main attraction to one of these plans is the flexibility they offer as far as how the money in the account can be spent. A bonus is the fact that monies roll over from month to month and year to year.

Breakdown of Health Insurance Costs in Franklin, ME

When paying for health insurance in Franklin, ME, the monthly amount that an individual pays to the insurance company is called the premium. The individual will not be reimbursed for this money, regardless of whether he or she uses that insurance. A deductible, by contrast, refers to additional expenses that individuals are required to pay to the healthcare provider before the insurance company begins to chip in.

Deductibles differ from out of pocket costs, insofar as deductibles refer to the amount individuals are required to pay before their insurance company will help with expenses for a particular purchase, while an out of pocket cost refers to the total amount of medical expenses individuals will have to pay before the insurance company will cover the rest of their expenses. In other words, an out of pocket cost covers nothing until the individuals reach a certain payment cap, after which the insurance company will take over the rest of his or her medical bills for the allotted time.

Deductibles and out of pocket costs usually reset at the beginning of each year. Normally, money spent one year will not roll over into the next, so if an individual spent $1200 out of pocket against his or her $3000 deductible, this will reset to $0 at the beginning of the year, with the $1200 expenditure from the previous year having no impact on the individual's costs. In Franklin, ME, however, some plans offer consumers an alternative to this annual reset by putting these out of pocket expenses towards the deductible for the first quarter of the new year.

There are also co-payments and co-insurance, terms that refer to the financial responsibility of the individual patient after receiving medical treatment. If an individual has a $10 co-payment for seeing a physician, this means he or she will have to pay this amount at every visit to the doctor's office. After the co-payment, the insurance covers the rest. Co-payments do not count towards the annual deductible.

Also, some insurance companies in Franklin, ME have a maximum lifetime benefit, which sets a limit on the total amount of money the insurance company will pay for an individual person's healthcare. If an individual reaches this limit, the insurance company will no longer pay his or her medical claims.

An individual's coverage options largely depend upon his or her current employment status. Large companies often provide employees with a group insurance plan, one that usually provides employees with a more affordable option than other plans, but isn't mandatory upon employment.

Those who are self-employed or unemployed, however, will have to seek insurance from a health insurance company for private individuals. For unemployed or retired seniors, coverage options are available through Medicare. Likewise, if an individual has a low income, he or she can sign up for Medicaid.

If an individual wants to keep his or her current primary care provider, the person should check to see which of the available Franklin, ME healthcare plans are accepted by that physician. On a similar note, everyone should make sure to tell their doctors after changing their insurance company, checking with the insurance company to find answers to any specific coverage questions they may have.

Get Quotes On Health Insurance Plans in Franklin, ME Online

Health insurance is one of the most important decisions you can make for yourself and your family. Make sure you take the time to consider all of the health insurance options available to you in Franklin, ME. As you assess all these factors in choosing a health insurance plan, MyRatePlan can help simplify the process greatly. Just enter your ZIP code above and see many ways in which you can save money on your health insurance policy.