Best Individual Health Plans For You

If you work for yourself, or if your company does not provide a group medical benefit, you probably need to shop for an individual health plan. This plan may just cover you, or it may also include your spouse and/or children. Insurers have developed many types of medical coverage to suit different types of customers, but it can be difficult to determine which plan will provide your family with satisfactory coverage at an affordable price. Let’s look at the major types of health insurance plans on the individual market today.

PPO (Preferred Provider Organization) – PPO health insurance plans are very popular because they have a network of medical providers to control costs, while allowing consumers to leave the network if they accept a lower level of coverage. In general, you will still get network coverage if you need to seek medical services for an emergency, even if you go outside the network. If your network does not provide a certain medical service which your need, they may also coverage that service at the network rate. However, you will need to get that service pre-authorized to be sure.
HMO (Health Maintenance Organization) – An HMO provides managed care where the health insurance company controls costs by only covering network provided health care. Again, an HMO will generally make an exception for emergencies or for certain services that are not included in their network.
HSA (Health Savings Account) – An HSA plan has two parts. One is a high deductible major medical plan, and the second is a savings account. HSA contributions can be deducted from taxes (within limits), earn interest, and roll over from year to year. The high deductible health plan may include a PPO network to help control costs.
Indemnity Health Insurance – This is a traditional health insurance plan that simply provides health insurance coverage for amounts over the deductible, and under the maximum specified in the policy.
Specified Benefit Plan or Mini Med Plan – The plans outline specific benefit amounts for different medical services. They may have lower deductible amounts than major medical plans, but tend to have much lower maximum limits for medical services.
So, which health plan is best for you? You need to consider your own expectations, needs, and budget. Your health insurance plan will not do you any good if you need to cancel it because the premiums cost too much. You may need to accept a higher deductible or more cost sharing than you desired in order to reduce monthly payments. When you buy health insurance on the individual market, you will certainly look at it differently than when an employer contributed a large portion of the premium.

If you live near a large HMO network provider, you may find that managed care really helps you control costs. However, many people enjoy the flexibility of a PPO because it still controls costs but does not require them to seek every treatment from the medical provider network. HSA plans work well for good savers because they allow the covered people to participate in the cost control process.

Comments are closed.