“You wouldn’t buy a car without knowing what’s under the hood. So why pick a health plan without knowing what’s inside?”

Let Me Tell You a Quick Story…

I once had a client tell me, “Rod, I just grabbed the cheapest plan because it looked like a good deal. Now, I’m drowning in medical bills I didn’t expect!”
And I get it—between premiums, deductibles, networks, and coinsurance, health insurance can feel like a foreign language. But the truth is, the cheapest option isn’t always the smartest. What you really need is clarity.

So let’s simplify the process into three steps that will help you confidently pick the right plan—without the headache.

Step 1: Understand the Basics

Let’s break down those confusing terms:

✅ Premium – What you pay each month, no matter what.
✅ Deductible – What you pay before your insurance starts sharing the costs.
✅ Copay & Coinsurance – Your share of the bill when you actually use healthcare services.
✅ Out-of-Pocket Maximum – The most you’ll pay in a year before your insurance covers everything else.

Think of it like a gym membership.
You pay your monthly fee (premium), but things like personal training (seeing a specialist) might cost extra (copay, deductible). You want to find a plan that gives you the services you use most, without paying for things you’ll never touch.

Step 2: Know Your Plan Types – HMO vs. PPO vs. EPO vs. POS

Each type of plan has its pros and cons:

✅ HMO (Health Maintenance Organization):
Budget-friendly, but you must stay in-network and get referrals to see specialists.

✅ PPO (Preferred Provider Organization):
More flexibility—go out-of-network and skip referrals—but you’ll pay more for the freedom.

✅ EPO (Exclusive Provider Organization):
No referrals needed, but still in-network only. A good middle ground for some.

✅ POS (Point of Service):
A hybrid—you can go out-of-network if your primary doctor refers you.

Think about your favorite streaming service.
An HMO is like the basic Netflix plan—limited access, but affordable. A PPO is like the premium package—access to everything, but it costs more. The right choice depends on how often and where you want to access care.

Step 3: Avoid These Common Mistakes

✅ Only looking at the premium:
A lower monthly cost may mean a much higher deductible or fewer covered services.

✅ Ignoring the provider network:
Always check that your current doctor, preferred hospital, and any specialists are covered.

✅ Skipping prescription coverage review:
Medications vary widely in price depending on the plan. Don’t get caught off guard.

I had a client call me in a panic—her regular doctor wasn’t covered under her new plan.
She had picked a low-cost HMO without checking the network. Now she had two options: pay out-of-pocket or find a new doctor. Either way, not ideal. Just five minutes of checking your providers and medications can save you a world of frustration.

📢 Need Help? Let’s Chat!

Still unsure which plan is best for you or your family? A quick chat could save you thousands in surprise bills and coverage gaps.

💡 Download my free PDF guide:
👉 Top 5 Benefits of Choosing a Nationwide PPO Plan

It’ll show you why flexibility, access, and peace of mind might be worth every penny.

Let’s make sense of your options—together.