Individual health care insurance and Individual health care insurance plans
Until recently, most people got their health insurance from their employer and people with low income got their insurance from the government. However, more and more people are now days buying private health insurance plans, tailor-made for individuals. The number of these individuals is currently estimated at over 13 million people, and growing. Statistics show that five percent of the population purchases private health coverage on an individual basis and that means that many people need to know more about individual health care providers, individual health care options and individual health care costs.
What exactly is Individual health insurance? Essentially, this term refers to coverage that a person buys independently. It can be sold to a single individual, to a parent and dependent children, or to a family. Each state separately regulates how individual policies may be marketed and sold.
Individual health care insurance is materially different than group health insurance, which is the type of insurance that is offered through an employer and it sometimes mean that the individual health care coverage is not the same. Since laws regulating what types of services must be included in individual policies are different than those dictating what must be included in group policies, benefits are normally less extensive than what most people would receive through coverage they have through their employment. That said, sometimes individual health insurance consumers have the option to pay extra for coverage of additional services like maternity coverage. Also, since insurance cost is often a prime factor for individual health insurance consumers, deductibles (i.e- the amount paid before insurance benefits begin) and cost-sharing (fees paid by the individual when service takes place) are also generally higher. Another important thing to note is that Individual health insurance companies are much more limited than group insurance companies in their ability to spread risk, so this results in applicants for individual health insurance having to complete a medical questionnaire when applying for benefits and, unlike a group insurance policy, in most states a company can decide not to cover people with serious medical conditions.
However, there are two considerable advantages of individual health insurance, when compared to a group type of health insurance: First, the coverage is customized. In group coverage, everyone ends up in a one-size-fits-all type of plan, even though the individuals comprising the group differ with regard to their needs. This way, in employer-sponsored coverage you end up paying for coverage you don’t need, or may have to go without coverage that you do need. Second, there is the important advantage of mobile coverage. This means that with an employer’s plan, leaving your job means leaving your health insurance, but Individual plans protect your health wherever your career takes you.
Once you have decided to purchase individual health insurance, you can buy plans through licensed health insurance salespeople, known as agents or brokers. Independent agents and brokers sell insurance plans from many companies, and they can help you find the coverage that best suits your individual needs.
The most common types of individual health care insurance include the following:
HMOs (Health Maintenance Organization). HMOs are one of the most affordable health plans available .HMOs create networks of health care providers. Most HMO networks consist of thousands of health care professionals, ensuring convenient access to medical care when you need it.
PPOs (Preferred Provider Organization) . this is an affordable individual health insurance plan with an added benefit —you can see any doctor or specialist you want, and your plan will cover the care.
Health Savings Account (HSA) Plans. There are 2 important parts to note regarding HSA coverage: a high-deductible plan and a Health Savings Account. The high-deductible plan provides catastrophic coverage and features low monthly premiums. The HSA is a tax-free savings account where you save money to pay for routine medical expenses.
Fee For Service (FFS) Plans. The FFS plan is the traditional form of individual health insurance: you get the care you need, then you’re reimbursed for a percentage of the cost.
Individual insurance is a good option if you work for a small company that does not offer health insurance or if you are self-employed. Buying individual insurance allows you to tailor a plan to fit your needs from the insurance company of your choice. It requires careful shopping, because coverage and costs vary from company to company. It is important to consider what medical services are covered, what benefits are paid, and how much you must pay in deductibles and coinsurance. Finding the right balance of coverage and cost can be challenging, but it’s a necessity. So take your search one step at a time.
As a general rule, If you’re a person who is in good health, you might want to consider a high-deductible PPO that’s compatible with a Health Savings Account. If you’d rather have more comprehensive individual health insurance coverage, such as preventive care coverage, consider a PPO or HMO plan with a lower deductible.
The following list provides factors to consider, when examining your next individual health insurance plan:
• Inpatient hospital services
• Physician visits (in the hospital)
• Office visits
• Medical tests and X-rays
• Prescription drugs
• Mental health care
• Home health care visits
• Rehabilitation facility care
• Physical therapy
• Hospice care
• Maternity care
• Preventive care and checkups
• Well-baby care
• Dental care
Good luck with choosing your individual health insurance plan !
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