Can someone please explain health care plans and choosing the right one to me like I am a five year old? I’m joining a new company and they have Cigna, I am a pretty healthy woman with no pre-existing conditions or anticipate any major health change. TIA

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Without seeing the plans/options, it’s hard to help. Further, whether your company pays some or all (or none) of the monthly premium costs are always a factor, along with your age.

All in all, I always suggest with going with a PPO plan. HMO plans require you to see your PCP first for a referral, and that’s annoying. On an HMO plan, you want to see a dermatologist, you have to see your PCP first. Want to see a gastroenterologist, you have to see your PCP first. Also, with HMO plans, you may get stuck in a specific network and if you want to see a specific doctor, say a dermatologist, but that dermatologist isn’t in the HMO network you participate in, you’d have to change your PCP to a doctor in the dermatologists network to see such dermatologist.

While there is cost savings with HMOs, in the long run, even if co-pays are minimal, I always choose a PPO plan. Less hassle and much more convenience.

As for PPOs, I always get the lowest deductible plan. It also ends up being the lowest out of pocket cost for you, but the premiums (monthly cost) are the most expensive. So again, if your company pays 100% of your monthly premium, get the best PPO plan you can!

Edit: I’m mostly healthy, but unexpectedly needed to have spinal fusion surgery at 39. Thank god for my PPO plan. I was able to research doctors and I picked the best spinal surgeon in-network. I would have had significantly more hassle and less options for surgeons if I was on an HMO plan.

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I’m a St Health Plan Analyst/Dental expert. If you send me the document I can explain things to you. I literally have to simplify plans everyday lol I’m a total nerd when it comes to this. The comments above are perfect but if you need specifics let me know.

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I like HDHP plans because my monthly premiums are low and I don’t go to the doctor a lot so any money I put in my HSA follows me year after year and can even be invested or used for retirement. But if you do go to the doctor frequently, be warned that it will be costly and a PPO might serve you better.

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