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Individual Health Insurance Plan Quotes
Individual health insurance is coverage purchased by an individual directly from an insurance company. You can purchase health insurance directly from an insurance company. Good candidates for Individual Health Insurance are often uninsured part-time workers and self-employed individuals without access to a group plan through an employer, union, or spouse.
Though group healthcare plans are technically more expensive than individual healthcare insurance plans, individual policies will generally have a higher out-of-pocket cost for you than group coverage. This happens because under group coverage your employer is often paying a portion of your premium. This lowers the cost to you.
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Individual Healthcare Insurance Coverage
Be aware that insurance companies are not obligated to sell healthcare to individuals that don't meet specific state or federal requirements. Additionally, even if you do meet requirements you may be deemed a "bad risk" and given lower benefits. Once you do have a policy, however, an insurer cannot cancel it if you get sick. The policy is guaranteed renewable if you pay your premium.
Tip: Before buying an individual healthcare policy, see if you belong to any associations that offer group health.
Individual healthcare plans, unlike group plans from an employer or association, can be more easily tailored to meet policyholder needs.
Two Types of Individual Health Plans
Eligible individuals can opt for an indemnity (fee-for-service) plan or a managed care solution. Types of managed care solutions include HMO, PPO, and POS plans (described below).
Both indemnity/fee-for-service plans and managed care plans cover various medical, surgical, and hospital expenses. Many also offer a prescription-drug and dental-care benefit. However, there are some important differences between indemnity/fee-for-service and managed care plans:
Indemnity/Fee-for-service: This is the most flexible and the most expensive option. Policyholders select the doctor of their choice and pay each time they receive services. You or your doctor then submit a claim to your insurance company for reimbursement, minus a negotiated deductible. You are reimbursed for the "covered" medical expenses listed in the plan's benefits summary. Generally, your insurance company pays 80 percent of the "reasonable and customary charge," while you pay a 20 percent coinsurance. Lifetime benefit limits also are set, usually at $1 million.
Managed Care: These plans provide comprehensive health services at a lower cost, but your choice of doctors is limited. You must pay for your coverage in advance, instead of per visit or service.
There are three popular types of managed or prepaid care: HMO, PPO, and POS. For more detail, see Individual Healthcare or Group Health.
Health Maintenance Organization (HMO): Patients pay a monthly or quarterly premium, whether they use the plan's services or not (but usually no deductibles or coinsurance). Modest co-payments are required for specific services, such as office visits and prescriptions. The upside: your medical care requires few out-of-pocket expenses. The downside: you are limited to doctors in your HMO network. Also, services by specialists are not always covered, even when approved by your primary care physician.
Preferred Provider Organization (PPO): These plans can be more costly than HMOs, but they also are more flexible, combining features of managed care and fee-for-service. In short, they will pay some reimbursement for covered services provided by doctors outside the plan. HMOs generally do not cover fees for doctors outside of your HMO netowork.
Point-of-Service Plan (POS): PPO and POS plans are the same, except POS plans have primary care physicians. PPO plans do not.
Good to Know About Individual Health Insurance Plans
Managed care plans can evaluate your condition to decide whether physician-recommended services are medically necessary. This is known as a "utilization review." If you don't want to risk denial of service, an indemnity/fee-for-service plan may be the better option. Also, please note that managed care plans use "discharge planning" to reduce expenses. Patients that don't require hospitalization are often transferred to more cost-effective facilities, such as nursing facilities.
Quick-list - shopping for individual health insurance quotes:
- Use the Internet to compare individual healthcare insurance plans and request medical insurance quotes. Costs for similar policies from different providers can vary widely.
- When comparing healthcare insurance policies, consider what medical services are covered, what benefits are paid, and how much you must pay in deductibles and co-insurance. Also review exclusions, such as if pre-existing conditions are exempt. (If the policy "Exclusions" section is short, look for limitations throughout the policy.)
- We recommend selecting an insurer with an excellent financial rating who can be trusted to pay its claims. Look for grades "A" to "AAA" and companies like A.M. Best and Standard and Poor's.
- Lower your risk to potential insurers by being serious about your healthcare and nutrition. Watch your weight, lower your blood pressure and cholesterol, and stop smoking.
- Obtain dental coverage and a prescription drug benefit in one policy.
- Lower premiums by increasing your deductible.
Request a quote from a top rated insurance provider, an find the best affordable health insurance for you. Get your free health insurance quotes online today.
