Individual Medical Insurance

Why Should I Buy Individual Medical Insurance?

The need for health insurance was recognized in the early part of the 20th century. The main reason to have it is simple: it can prevent you from facing financial ruin if there is a catastrophic illness or accident involving you or your family. At such a time, it is hard enough to deal with your health problems without the added knowledge that huge medical bills are exhausting your savings and future financial independence. You probably already know health insurance is something you should never be without.

Individual VS Group Health Insurance

There are two general categories of health insurance available today: individual and group. Generally, a good health insurance policy will cover several types of medical requirements. For physician’s fees, insurance should cover both office and hospital visits. In relation to the hospital, insurance should pay for your room and your services while there, although some treatments may be written into the policy as optional. Surgical fees and related costs, as well as lab and x-ray services, are usually covered. There are many options that can be written into a policy. Whether you are shopping for either individual or group insurance, you should put thought into the specifics of what you and your family need.

Who Should Buy Individual Medical Insurance?

Individual insurance is bought by those of us who have to provide health insurance for themselves. This may be for several reasons: for instance, if you are self-employed; if you work for a small business that does not provide a health plan or if you have a family and want individual insurance. In an individual plan, you will have a premium to pay yearly and a deductible for each insured dependent, up to a base amount. This deductible comes out of your pocket before insurance will start to pay a percentage of the next medical fees. The percentage of fees or co-insurance is the amount the health plan will pay for covered expenses (often 80%), as set up when the policy is written.

What will My Deductible Be?

Whether the insurance is individual or group, the amount of the deductible is determined at the time the policy is written and is decided by the person, group or business which sets up the health plan. In both types, you will have out-of-pocket expenses besides the deductible mentioned above. These include the percentage of fees your plan does not pay (often 20%) and any uncovered medical services not included in your insurance policy.

What’s a HOM – PPO – POS?

HMO emphasize health and wellness while managing medical costs, ensuring clients receive all the services they need, but none that are unnecessary. Your care is normally coordinated by your primary care physician or PCP for short. Monthly out of pocket cost normal are the lowest.

PPO offer the greatest freedom of choice by providing in-network and out-of-network options. Monthly out of pocket costs are normally the highest.

POS are combinations of HMO and PPO plans they offer a network of providers you pay less while having the freedom to go out of network but pay more. Monthly out of pocket costs are normally in the middle of low and high costs.

What’s my deductible? What’s my out of pocket limit? What’s my deductible?

How much will an office visit cost me or how much will it cost me if I have to go to the emergency room?

What about preventative services – am I covered?

Let’s explore your questions and options together.

Whatever health plan you have, look at it as a contract between you and your insurance company in which you both consent to all agreements made when setting up the plan.