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The widely-discussed reform of healthcare industry in the US owes much of the stir around it to the simple fact that having your health insured in our country isn't affordable for millions of people of different demographic groups. In other words, it's just too expensive to be within the family budget of most US citizens. But how much does it cost to get your health insured these days, anyway?

This strongly depends on several factors that may vary your cost significantly. Things like your health condition, age, workplace, location, income and other live factors play a very important role in shaping your final rates. Not to mention the provider you're getting your coverage from. The form in which you get your health insured also plays a crucial role, because getting your insurance in a group from your employer usually costs less than if getting it on your own.

But what comprises the final insurance costs?

Many people get confused by the fact that there are more elements to insurance costs than just the rates you seen when quoting your price. Here are the most important of them:

Premiums

Premiums are periodic fees (usually, monthly) that have to be paid to the insurance company for receiving any medical services under your plan. If you have an individual plan then you are paying your premiums on your own. If you are covered under a group plan at work, your employer pays the premiums, usually requiring you to pay a small part of this amount. Premiums depend on your health condition, your age and your income status. Premiums also vary significantly between insurance companies, so you'd better spend some time on comparing health insurance quotes before you sign your plan.

Out-of-Pocket expenses

Out-of-pocket expenses are all the additional costs of health insurance plans that are extended beyond premiums. These usually include deductibles, co-payments and co-insurance. With some plans these expenses can be limited to a maximum amount, while other plans have no limitations at all, so be on the lookout for that.

Deductible is the amount of money you have to pay on an annual basis before your actual coverage kicks in. You will most commonly encounter them in PPO plans for the services received outside the network. And as with other types of insurance products, you will have to pay lower premiums if your deductible is higher.

Coinsurance is the part of the medical cost you have to meet after paying the annual deductible. It is usually 20-30% of what you pay for the services when going to the doctor.

Co-payments represent a fixed fee for certain services within your plan. In many HMO and PPO insurance plans co-payments are set for things like doctor's visit or prescription medications.

And what are the average costs?

• Across the US, the premium is $2,985 for individual health insurance and $6,328 for a family plan.
• The annual premium differs significantly between states. If a family in New York had to pay $13,296 as an annual premium, the very same plan in Iowa was worth $5609.
• The amount of deductible paid has a strong effect on the annual premium. A family plan that had no deductible had a premium of $12686, while a $10,000 deductible shed this amount more than in half, with $5380 to be paid.

Fee-for-Service or indemnity plans are the oldest type of health coverage out there, providing you with the greatest extent of flexibility. You are absolutely free to choose the doctor, specialist, surgeon or even the place you will receive your medical service from and it doesn't require any approvals or referrals from other institutions. So what's the catch?

The drawback of Fee-for-service plans is that they are quite costly and usually have higher deductibles than managed care plans. Besides, you will also have to pay a large part of your actual medical bill out of pocket. That's the price you have to pay in order to obtain the flexibility provided by these plans. But this doesn't mean that there are completely no restrictions with fee-for-service plans.

For instance, fee-for-service health insurance plans will not provide coverage for preventive healthcare services, meaning that any vaccinations, regular check-ups and physical exams will be paid for entirely out of the customer's pocket. This makes fee-for-service plans quite inconvenient for families who need regular medical services and doctor consulting.

Fee-for-service plans require an annual deductible to be paid in order to receive the coverage benefits from the insurance provider. Once you do so, your medical expenses are distributed between you and the insurance carrier. You will usually pay something between 20% and 30% of the entire service fee and your insurance company will cover the rest. So it's really important to choose a plan that has a smaller co-insurance (the part you have to pay out of pocket) before actually purchasing it.

With most fee-for-service plans you also have the so-called "caps" that are basically the upper limits of your yearly deductibles. These can be anything from $1,000 to $5,000 not taking your monthly premiums into account. So it's better to see what your plan carries before signing it if you really want cheap health insurance with fee-for-service.

On the other hand, fee-for-service plans offer comprehensive and timely coverage when you need it, especially when there's a medical emergency. You are completely free of the bureaucratic restrictions and setbacks of typical managed care plans that can turn down any desire to receive medical assistance in the first place. However, bear in mind that fee-for-service plans won't be suitable and attractive for everyone. If you want to get comprehensive coverage for preventive care or have a large family with diverse healthcare needs you better investigate managed care plan options instead of indemnity plans.

And don't forget about comparison shopping when purchasing fee-for-service coverage. Try to get as many health insurance quotes from different providers as possible and compare them in detail. You will be surprised to find out that different companies have different premiums, "caps" and co-payments that will all contribute to the final cost of your insurance coverage. So it's always better to take some time comparing you options rather than complaining that you have a costly insurance plan after purchasing it.

When it comes to health coverage these days, we sure have a lot of various options to choose from. One of such options, which has become quite popular lately are Point Of Service (POS) plans that can be viewed as a mix of traditional indemnity and modern managed coverage options. And what such a combination provides you with are money saving potential and flexibility, all in a single package.

Health coverage on two levels at once

People familiar with HMO plans can easily see the similarity between HMOs and PPOs when it comes to organizing the services. Here you are also required to choose a PCP (Primary Care Physician), who will coordinate your services and provide referrals to other specialists within the network when required. But you are also free to choose any facility or physician that doesn't make a part of the specified network. And a POS plan will pay for such services out of the network, however to a narrower extent than with in-network services. So it will still cost you less to get your services within the POS network.

This is what is meant by two levels of insurance coverage, which are called "in plan" and "out of plan" health insurance. In plan coverage is usually more advantageous but it also has tighter restrictions imposed on the user. Like in case of HMO plans, in order to get full coverage at the "in plan" level you will have to provide a referral from your PCP and get your services within the network. You will also sometimes be required to get additional approval from your insurance administrator beforehand.

This all means that even sticking to the specialists and facilities of your POS network won't give you full coverage unless you provide a referral from your PCP. This is the so called "red tape", which is one of the biggest complaints about managed insurance plans and the formalities within them. However, when compared to indemnity plans, managed health care provides substantial money saving possibilities that can't be beaten.

The indemnity part of POS

POS plans provide the best of both worlds, that's why they are so popular. And when it comes to the indemnity part of POS plans, people find a lot of flexibility and freedom that just can't be obtained through typical managed care options. Just like in the case of PPO plans, you are still able to get insurance coverage even when addressing to a specialist outside of the POS provider network.

In other words, you can use "self-referrals" in order to get care from a specialist you choose. When treatment is required, you are free to choose any physician or facility without needing a special referral from your PCP, Still, you won't get much coverage when choosing this option, so flexibility still has its price.

However, this is a great way to avoid the restrictions typical for managed care plans. That will be very useful for those who have a long-term trusted physician outside the network. Still, in such a case you will have high co-insurance payments (up to 40%) that will make your visits a bit more costly if compared to a doctor from the POS network.

Finding the right plan

In order to get cheap health insurance with your POS plan you have to shop around first. Try getting as much health insurance quotes from different providers as you can, compare them and choose the right policy.

Having an Exclusive Provider Organization (EPO) means that the medical service providers you will receive care from should have signed up an agreement with the insurance company to allow offering you these services. This way EPO plans are somewhat similar to PPO (Preferred Provider Organization) plans, meaning that the person having such a plan can obtain inexpensive medical services at a facility that makes part of the EPO network. Still, if you choose to receive your medical care at a facility outside the network, a PPO plan will still cover your costs, only to a smaller extent. With most EPO plans, you won't receive any insurance coverage when visiting a specialist outside the network.

When you choose an EPO plan, you will instantly notice that the fees you are charged with by the medical service providers that have accepted to join your insurance company's network are significantly lower than those normally charged. So when you receive your health benefits within the EPO network, you can rest assured that the rates you will be charged for the services will be very advantageous and your insurance provider will pay for all the services you receive.

However, if you have a condition that none of the specialists making part of the EPO network can help you with and you are forced to seek medical attention outside of the network, make sure you have enough money because you will pay for the service to the full extent. This is because EPO plans do not include any services provided outside the selection of facilities and specialists that have an agreement with the insurance carrier. Moreover, in contrast with PPO and HMO plans that have fairly large networks of health service providers, EPO plans usually have a much smaller number of specialists and facilities being part of their network. This means that you have fewer professionals to choose from when you need medical attention.

In what concerns health service providers, their advantage in joining an EPO network is in the increased number of patients they work with. So instead of charging higher rates to a smaller number of patients, they charge lower rates for a much higher number of people and get more revenue as a result. This is especially useful to those providers who target themselves at a certain geographical area and want to get more people through group health insurance plans. The insurance companies, which choose to provide EPO plans charge their customers with monthly premiums and act as mediators between the customers and the medical service providers.

As a conclusion, EPO plans would definitely be appealing to those looking for cheap health insurance and having no special medical needs such as pre-existing conditions. The group of people who will probably benefit the most from such plans are young healthy workers with no serious health risks. And those who will find EPO plans quite uncomfortable are older people with complicated conditions that need regular and special care from certain specialist, who may be outside the network. Think well before you purchase such a plan and make sure to shop around to get the best rates. Use health insurance quotes online or contact your agent to see what local providers can offer and start from there.

Often, California has been in the lead when it comes to legislating for fairness. When a service industry is acting in an arbitrary way and damaging the interests of consumers, you can usually rely on Sacramento to do something about it. So, for example, the Insurance Commissioner instructed auto insurance companies not to rely on ZIP codes when writing policies. The real basis on which to assess risk should always be the individual driver. It's fair to look at the person's experience, driving record, how far he or she drives every year, etc. That way you reward the good drivers with lower premiums and hit the bad drivers with higher premiums. This ends the discriminations of higher premiums for people living in predominantly black or Latino communities.

It would be great if we could see this change sweeping across the US, not just in auto insurance, but for all classes of insurance. Unfortunately, the insurance industry has fought the change tooth and nail wherever it has been proposed. Lobbyists with deep pockets have been able to keep the legislators at bay. The ZIP code approach remains the norm.

The most recent piece of research comes out of Chicago and relates to health plans. It seems it's cheaper to live in the suburbs. The research used just over 3,000 ZIP codes in the Chicago area and, when analysing the rates charged, found that people living in the blue-collar suburbs west and south of Chicago paid almost 25% less for their insurance than those living in the downtown areas. Similarly, the residents of the northern suburbs paid about 15% less. Spread the net more widely and it turns out that everyone living between 15 and 25 miles from the downtown area pays an average of 13.5% less, while those who have moved 25 to 40 miles out of the city pay an average 25% less.

There are obvious explanations. The hospitals and clinics in different areas attract doctors and healthcare providers with different levels of experience and expertise. Operating costs will also change with local conditions. The level of support for public facilities and programs from local government naturally varies depending on the local tax take and political factors. These affect the rates for services the insurers can negotiate with the local provider networks. And then there are all the intangible factors based on the wealth or poverty of an area, the percentage of people without current health insurance, and so on. Put everything together and profiling by geography may produce very different results. This leaves us with an uncomfortable reality. As it stands, the health insurance industry is unregulated. It can charge what it likes using whatever factors it wishes to consider significant. As and when the healthcare reforms pass through Congress, some practices that produce unfairness will disappear, e.g. no more discrimination based on gender, no more discrimination by denying coverage to people with pre-existing conditions, no more caps on lifetime benefits, and so on. But the ZIP code abuse will not be affected. No matter where you live, you will be judged not on your actual health records but the "accident" of your address. Perhaps you should consider relocating to a better area to get the best health insurance rates.

Today there are many ways you can get affordable health insurance. You can contact an insurance agent by phone or browse for quotes online, and the number of offers you will get will definitely make a good comparison shopping experience. But before your set your mind on comparing the prices, first make sure you understand what coverage types your policy offers and select the one that covers your exact needs. Here are four tips on how to get the most affordable coverage and get the best of your current health insurance policy.

1. What coverage type is best for you?

It's a common pitfall of many inexperienced insurance shoppers to get the first cheap insurance offer without learning what it covers and to what extent. After all, health insurance should cover your specific needs that are strongly influenced by a set of circumstances. Here are the most influential factors determining the type of insurance you might want to get:

Working. The best choice here would be an employer-sponsored group health insurance plan. You can also get an individual insurance plan or opt for state sponsored coverage (in case your income is low).

Self-employed. The most common choice her is an independent insurance plan or a state sponsored policy (for low income individuals).

Unemployed. If you have recently been laid off from a job then it would be best to consider Cobra coverage, or typical state sponsored health insurance.

Student. College students can also go with Cobra pr state provided health insurance coverage.

2. Which insurance company to go with?

When you have defined what type of health insurance suits your needs, it's time to decide which company to get it from. As with any business, there are big reputable companies, medium-sized providers and small businesses, which all offer competitive rates and a wide selection of plans. What company to go with depends on the type of insurance you are looking for, the state you live in and of course the reputation of the company. Try getting health insurance quotes online to see what companies are available in your area or contact your state insurance department to learn if there are any complaints about a particular company. Word of mouth is also a good source of information.

3. Discussing the policy

When you have already decided on the offer, got the health insurance quotes and are ready to make the call to the company or apply for the policy online, it's important to discuss all the provisions of the plan before actually purchasing and signing it. Learn what is included and what is not, especially the things you feel most important to you like pre-existing conditions.

4. Understanding the coverage

Now that the policy is purchased makes sure to learn all about coverage types and amounts delivered buy it. You can ask you insurance agent for an explanation or can read the policy on your own. Of course, it may look a bit confusing at first but it contains all the benefits you will receive when needed so it really makes sense to learn about your coverage actually before putting it to use.