Insurance companies around the nation currently offer individual health insurance plans for those who do not have access to group plans through an employer. In choosing an individual plan, one of the most confusing factors is determining the cost when compared to the plan’s benefits. It is necessary to compare several plans in order to choose the individual plan that best suits your needs with regards to premium cost as well as services covered.
When choosing the individual health insurance plan that is best for you, it is a good idea to do your research and compare several plans before settling on one. You should consider different factors such as the choice of doctors offered through specific plans. If you have a preferred doctor and want to keep that doctor, your choices of insurance may be limited. Typically HMOs require that you use a physician that is included in their network to receive coverage benefits. If you want to keep your existing physician, a PPO plan may be your best choice.
You will need to determine what your total expenses will be with any given plan. For instance, you will need to determine both your out of pocket expenses and the cost of your premiums when calculating the total cost of your health insurance plan. A comprehensive insurance plan offers a more cost-effective approach to insurance. If you would rather incur fewer out of pocket expenses, an HMO is the best choice. However, if you are a younger adult and have no children, you can choose a plan that basically covers only catastrophic illnesses and injuries such as a major medical plan.
You will need to determine whether or not you need prescription drug coverage as well. If you are currently taking prescriptions, make sure that the plan you choose will pay for those medicines. You should also ensure that your chosen health insurance plan pays for diagnostic x-rays and other routine tests that may need to be done on a routine basis. Some plans may also limit the specialists that you can visit. If you want to visit a chiropractor for instance, this service may not be covered by specific health insurance plans. It is always wise to read the fine print and determine just what services are covered in your plan and what services you will be required to pay for.
In order to choose the best individual health insurance plan, it is important that you understand the different types of health insurance that are available and the advantages of each including Fee-For-Service or FFS plans, Health Maintenance Organizations or HMOs, Point Of Service Plans or POS and Preferred Provider Organizations or PPOs. Each plan will have its own benefits to consider when choosing the one that best suits your needs.
Fee for Service or FFS plans offer flexibility in coverage in exchange for a higher percentage of paperwork, higher premiums and more out of pocket expenses. The major advantages of FFS plans include allowing you to choose your own physicians and healthcare facilities. FFS plans do not include networks of doctors from which you must choose. They allow you to visit a specialist without a referral from your primary care physician.
Health Maintenance Organizations or HMOs are typically the least expensive choice with regards to individual health insurance. They are also the least flexible with regards to services and coverage. Advantages of enrolling in a plan with an HMO include lower copayments as well as minimal paperwork. They offer a large selection of physicians and healthcare facilities in their network and typically include only a moderate copayment for visits to physicians included in the network. Covered services typically include medical treatments, outpatient services, physician services, short-term mental health care and inpatient as well as outpatient emergency room treatments.
Point of Service or POS Plans are more flexible than standard HMOs but they do require that you choose a primary care physician. You may choose to visit a doctor who is not included in their network and still be covered, but the covered amount will be much less. POS plans do tend to provide more preventive care than other plan types however.
PPO or Preferred Provider Organization plans offer a financial incentive to purchasing a policy. In addition, the copayments associated with PPO plans are typically much lower than other plan types. The average PPO copayment for a visit to your physician during regular office hours is $10. PPO plans also allow you to visit any specialist without a referral from your primary care physician but your specialist must participate in their network.