In order to make a wise decision about health insurance, it’s helpful to compare several different plans. The most common points of comparison will be cost, choice, and benefits. There are four categories of costs associated with health insurance. Premium: the monthly payment you make to maintain your health insurance coverage (Typically less than $100 for a healthy 20-something.) Deductible: the amount you must pay for covered services before medical expenses are paid by the health plan. (Can range from $0 to $10,000) Co-payment: the amount you pay—usually $10 to $25—for each office visit or prescription Co-insurance: the percentage you must pay of each medical expense, after co-payments and deductibles are met (typically 20 percent) Co-payments + co-insurance = cost sharing, a term you will often see on insurance documents. To view Regional Examples of Health Insurance Costs, click here. A crucial way health insurance plans differ is in the amount of choice and degree of flexibility you have in choosing your own doctors, specialists, and hospitals. LEAST CHOICE Health maintenance organization (HMO): an insurance plan that requires a person to get care from providers who are part of the HMOs network. Usually, a primary care provider coordinates care and controls access to specialists. Point of service plan (POS): an option added to many HMOs allowing enrollees to seek care outside of the HMO’s network for a higher co-pay and, possibly, a higher premium. Preferred provider organization (PPO): an insurance plan that encourages enrollees to get care from providers within the plan’s network, but allows access to providers outside the network if one is willing to pay more. Many PPOs do not require the insured person to choose a primary care doctor or get a referral to see a specialist. MOST CHOICE Fee-for-service (FFS) plan: Once the most common kind of health care policy, FFS plans offer the greatest amount of choice, in exchange for the highest costs. Under an FFS plan, you can choose any doctor you wish and change doctors any time. This is also known as indemnity or traditional health insurance. What will be covered under your new health insurance policy? This is an important point of comparison in selecting a new plan, and one that should be governed entirely by your own habits and preferences. For example, some of the lowest-cost plans do not offer pregnancy and delivery coverage. Others may not cover mental health services or substance-abuse treatment. Don’t wait until you get sick to buy health insurance! However, if you have a pre-existing medical condition—a recent illness or injury—then that could affect the benefits you can receive under your new plan. Insurance companies can even refuse to cover you at all except in some states. GUARANTEED ISSUE Idaho – Maine – Massachusetts – New Jersey – New York – Vermont are states where insurance companies cannot reject you for coverage because of your health status. If the company does agree to cover you, it may exclude coverage for the pre-existing condition(s) for a period of time, usually a year or longer.