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ShoppingSpot > Choosing a Health Plan

Choosing a Health Plan

Confronted with the options of PPOs, HMOs and EPOs, choosing a health plan can seem like digging into a bowl of alphabet soup. But it doesn't have to be so confusing. The Internet offers a wide range of sites that can help you make sense of it all.

"The Web expands the information available about plans," said Carolyn Clancy, M.D., director of the Center for Outcomes and Effectiveness Research, a division of the government's Agency for Healthcare Research and Quality. Dr. Clancy cites two major challenges: determining the quality of a plan and weighing what features are most relevant to you.

When possible, seek information from unbiased third parties, such as government agencies or independent rating groups. To narrow down your options, follow these strategies:

Assess Your Health Needs

The search for insurance should start with your own needs. Consumers Union, publisher of Consumer Reports, offers a Choosing a Health Plan page that presents questions you should consider. If you have a chronic condition or costly medications, for instance, those should factor into your decision.




Understand Your Options

There are several varieties of insurance plans. Most familiar is the indemnity (fee-for-service) plan, in which the client has a choice of doctors and submits a claim to the provider. But managed care options like HMOs and PPOs are becoming more and more common. The Agency for Healthcare Research and Quality explains the options with Choosing and Using a Health Plan. Because the services and fees offered by HMOs can vary widely, check out the Consumer Reports article "Is an HMO right for you?"

Compare Services

The National Commission for Quality Assurance evaluates how different plans rate on access to services, qualified providers and more. Healthgrades.com also provides comparisons.

The Web sites for individual providers can also help you sort out differences. "Many plans are accredited by the NCQA, so if a plan does well, it would likely advertise that on its site," said Dr. Clancy.




   --- M. Magnarelli

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