3 Terms you Must Know When Exploring Health Insurance Plans Dr. Noor Ali, MD, MPH, CPH

Insurance, yuck! Health Insurance, oh goodness, no thank you! If the first word that comes into your head when you think insurance is “scam”, then this is a read for you.

Take it from me...I come from a background where insurance is not even a thing! I grew up an immigrant New York City girl but went back to my home country, Bangladesh, for medical school. As a new and developing country with extremely low resources, this country’s healthcare system is still catching up to the rest of the world. So service and delivery for medical care is more on a pay-per-fee service.

Fast forward a decade, when I moved back to the states, I was approached and overwhelmed by medicine placed in an entirely new healthcare system. And, to use the word “complicated” would be an understatement! To excel in my environment and effectively help the population I was serving, I had to learn this complex and cumbersome system. I proceeded to get licensed in the health insurance field and obtain certifications Not only that, I made it a mission to learn enough to educate people on health insurance so they can make the best, most informed decisions for them.

I think a large part of why the topic of health insurance is dismissed is fear of the unknown. The terms of the industry are unfamiliar, so it’s written off as “indigestible” therefore, “displeasing”.

Here are 3 terms of the trade that you need to understand, that will help you evaluate your options easier:

1. Premium – The monthly payment that you have to pay to have the policy. This is typically due at the same time each month for as long as you have the policy. Some employers deduct this amount from your paycheck. Most companies have a 30-day grace period if you are late on a premium payment.

2. Deductible – This is the amount of money you have to pay out of pocket in full medical costs before your insurance company will pay out benefits according to your policy. Deductibles vary from plan to plan. Higher deductible plans can have lower premiums, but not always, so be aware of your plans’ premiums and deductibles. A very common misconception, especially among younger generations, is that the younger and healthier they are, the higher deductible plan they should be on because they hardly ever use their plan or get sick. On the contrary! It could mean that they are paying into a health insurance plan that they hardly get to utilize benefits for until an unlikely high deductible is met.

3. Network – Your health insurance network dictates which doctor, provider, hospital and medical centers you can go to that will accept your insurance plan. Typically, the three main types of networks are Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), and Exclusive Provider Organization (EPO). A PPO network is nationwide; it is the largest type of network and crosses state lines for coverage. It’s a good idea to look up your preferred doctor or provider before signing up for an insurance plan to confirm that they are in-network and will accept your plan.

When evaluating whether or not an insurance plan is right for you, it’s important to consider these points so you can compare apples to apples. All insurance plans are not the same and each policy is created with many layers of coverage sandwiched with riders, limitations and exclusions.

My current business practice in USA helps individuals and families and small businesses understand all their different options for health insurance and pick a plan that makes sense for them. If I can help figure that out for you, just reach out! All consultations and services are FREE.

-Dr. Noor is a Bangladeshi American medical doctor turned health insurance expert who helps educate and inform the public so they can be empowered to make better choices for their health insurance. As a first time mom and woman of science, she is all about lifting other women up and helping them tap into their "mom strength" to achieve their biggest goals. She currently lives in Tampa, Florida and works with clients all over the USA. Her medical practice is entirely voluntary and she works in clinical practice in her native country. She is currently working on scaling her health insurance consulting practice and helping as many female entrepreneurs as possible on the way up!

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