Insurance Information : Major Types of Individual Health Insurance Policies
In a country like the United States, if you do not want to be buried in debt; you need a good health insurance for yourself and your family. Whether you are an employee or self-employed, it is necessary that you have a good health insurance coverage to cover your medical bills. However, there is no unique health insurance plan good for every one; benefits and costs vary from an individual to another (due to age, medical condition, etc.). To make a good choice, you need to know what benefits you are looking for, and examine each plan to find the one that best responses to your needs.
Although you have many options in choosing your health insurance, finding the right plan can be difficult. In general, individual health insurance is a form of contract between you and an insurer (insurance company )to repay all or almost all of your medical bills, which may includes hospitalization, medications, dental care, seeing a specialist, and certain therapies (radiotherapy, chemotherapy, etc.). Whatever your needs, you will most likely have to choose one of these plans, Fee-for-service, HMOs (Health Maintenance Organizations), or (PPOs) participating provider organization.
Fee-for-service – also known as indemnity plans, is a type of insurance plan where you, patient, have to pay all medical expenses out of your own pockets, and then request a reimbursement from your insurance company. These types of plans have their advantages and disadvantages.
Advantages: they offer more flexibility in choosing your own doctor. You can decide the time to see your health care provider, and what type of treatment you want; as long as you remain in the limit that your insurer will repay
Disadvantages: in indemnity plans, most doctors require upfront payment, so you have to submit claim forms to the insurance company to receive a reimbursement. That requires paper work, and sometimes many phone calls. Fee-for-service plans offer limited benefits; they do not cover annual physical exam and educational programs.
HMOs (Health Maintenance Organizations) – Health maintenance organizations (HMOs) are managed care plans that offer health care coverage to their members through hospitals, doctors, and other health care providers that are in their network. That is, having their service, you are limited to members of their network.
Advantages: unlike Fee-for-service plans, you do not have to pay up front; although some of them require a copayment. You do not need to submit forms after forms to receive reimbursement. In addition, HMOs usually charge a lower cost.
Disadvantages: you can use only health care providers who are associated with the organization. Most HMOs (Health Maintenance Organizations) tend to disapprove certain treatments. Although some HMOs accept their members to see physician or specialists who are not in their network, they often charge you additional costs.
(PPOs) participating provider organization – also known as Preferred Provider Organizations, is a form of managed care organization of physicians , hospitals, clinics and other health care providers that sign a contract with an insurer to provide health services to its member at reduced rates . Usually, PPOs cost more than traditional HMOs, but offer more options to their members.
Advantages: Preferred Provider Organizations provide more flexibility to their members; they have a bigger network of doctors and hospitals. You can take service from health care providers that are not part of their networks (certain charges often apply). You pay Lower copayments for care from primary care physicians. In addition, you do not need a referral to see a specialist.
Disadvantages: PPOs cost more than traditional HMOs. You will more likely to make co-payments (usually from $10 to $30) when you visit a health specialist.
Do some health insurance companies offer better service to their members than others?
Yes. Some insurers offer better service to their members. To learn more about health insurance companies that provide satisfying individual health insurance plan in the US, visit our top rated list visit careand.com, or click on the link in About Author/Resource box.
Watch the video related to individual health insurance
The two major types of individual health insurance policies are health maintenance organizations, or HMOs, and preferred provider organizations, or PPOs. Find out how HMOs and PPOs provide a pool of doctors for the insured to visit with information from alicensed life and health insurance representative in this free video on insurance. Expert: John Pinelli Bio: John Pinelli is a financial service broker for Northwestern Mutual Insurance. Filmmaker: Bing Hu…
Help answer the question about individual health insurance
where can i get individual health insurance for me and my daughter that also covers pregnancy in connecticut?I need to get health insurance for me and my 1 year old daughter. I am planning on becoming, or possibly already am pregnant but need insurance for us. Any help? This is in CT, so it is a state that does not require individual policies to cover pregnancy.
About Author
Remy is a multi-topic writer with years of experience. He loves to share his personal experience with others. For your research on health care insurance, please visit care and insurance .
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18 Responses to “Insurance Information : Major Types of Individual Health Insurance Policies”
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May 5th, 2009 at 7:12 am
We had this system once; a long time ago. We chose to change it. And now it’s time to take another step forward.
May 5th, 2009 at 7:12 am
Imagine if, in 1966, then President Lyndon B. Johnson had tried to determine what the emissions levels of America should be 42 years into the future. Even if he had gotten together the best and brightest minds of the day, it is unlikely that his advisers would have come up with data that could have anticipated either our energy needs or our standard of living today. Lawmakers wont admit it but, policymakers today are similarly handicapped when it comes to predicting our future needs
May 5th, 2009 at 10:40 am
Even with the fact that it is not in the constitution to have “free” national healthcare, We are already broke and in massive debt. Bush put us in more debt than any other president combined and now Obama has already (without healthcare spent more accumulated more debt) than any other president (inc. Bush) COMBINED. The fact is we cannot afford it. Our dollar is worth 4 cents of what it was in 1913. The Federal Reserve (the true culprit of boom bust cycle) is inflating like never before. EVER.
May 5th, 2009 at 7:13 am
No, it doesn't work that way. Most carriers require you to agree to cancel your existing policy when you apply for your new one, and if you have two policies one is going to be primary, and the other secondary. You will reap the benefits of the better plan, but where they overlap, only one will pay.
What you might want is be a supplemental or limited benefit plan to go along with your insurance policy. These are not insurance policies and I usually don't recommend them. I think your money would be better spent buying a better single policy, or an HSA type of plan and banking the savings.
Don
http://mtnhealthinsurance.com
May 5th, 2009 at 7:15 am
Most major US health insurance companies require a person to have lived in the US at least 6 months to 1 year.
Your best bet will be to find a worldwide international travel health insurance company and get a plan from them for a year or so until you are eligible for a regular US individual health insurance policy.
Here is some more information on international travel health insurance plans:
May 5th, 2009 at 4:09 pm
Let’s recognize that many of these problems exist in an individual market. Until individual coverage is changed across all states; people will continue to be denied or coverage rescinded. Healthcare also does not belong in the employer market. Optimal health of our people should be a priority for our country; as Americans we should demand the best and bolster any way we can. We support other industries that pollute our air and contaminate our land and water without any after-thought.
May 5th, 2009 at 6:51 pm
True, still they are not private. Think of all policemen being like “dog the bounty hunter”, and asking you for an insurance card before providing their service to you. Would you like that? What about firemen coming to the front of your burning house and just watching it burn down because you had no “coverage”.
May 5th, 2009 at 5:55 pm
all them are different.
I think blue cruz
May 6th, 2009 at 3:17 am
mailbuhur12, We ALREADY pay much more than any other country in the world. 19% of GDP; that is direct costs, without counting all the costs related to bankruptcies, lost job mobility, lost time by patients, opportunity cost of patients time who have to spend hours and hours arguing with insurance companies, etc. The only one getting a free lunch are insurance companies, they just take the cash while medicare and medicaide are stuck with the risky patients.
May 6th, 2009 at 4:02 am
Talk to a local, independent agent about finding coverage that excludes the whole apnea situation.
May 6th, 2009 at 11:26 am
Yes you can use it as a tax write off.
May 6th, 2009 at 12:08 pm
There are many web sites online that offer health insurance quotes you can compare with no obligation.
Some health insurance plans may include coverage for pregnancy. You want to check with the plan when requesting your quotes.
Ask about pre-existing conditions coverage in the health plan and how your coverage and deductibles are applied to pregnancy – What exactly is covered. This way you won't be surprised when you need the coverage during your pregnancy.
You want to make sure you understand the coverages offered, coverage limits, deductibles, co-pays, and exclusions for any pre-existing conditions.
I recommend the two top-rated health insurance quote providers:
1) InsureMe – they give you the five best health insurance quotes from top-rated health insurers nationwide. To Request a free, no obligation quote, Go to – http://www.insureme.com/landing.aspx?Refby=613598&Type=health
2) eHealthinsurance.com offers you side-by-side quote comparisons from a large network of health insurers across the country.
I hope that helps! Take care and best of luck!
May 6th, 2009 at 2:04 pm
Hi,
Generally it is not a good idea to have more than one health insurance plan because only one will be your primary coverage. You need to be careful if you want secondary coverage. Many policies will not allow you to get a policy if you already have a policy.
Having said that, there are supplemental plans that pay YOU instead of the doctor or hospital. They are with companies such as Aflac and are supplemental plans. They are set up so that you get a certain dollar amount for each doctors visit, emergency room visit, hospital stay, or surgery.
While I represent individual insurance companies I don't generally recommend these supplemental type plans unless you go with an HSA where you don't have co payments and you have a high hospital deductible.
But you get what you pay for with insurance. If you want low co payments and deductibles then your premium will be high. I would recommend getting a primary plan that is good enough and saving money to pay co payments and deductibles.
I hope this helps.
May 6th, 2009 at 11:50 pm
卍, tells you, anything is, Correct, 卍 !!! 卐 Is the force of gravity electricity generation, d 卍
May 7th, 2009 at 7:26 am
I had BCBS @17 yrs @$7500 I used it one time in the 17th yr the OBGYN gave me Vioxx & Liquid narcotics for Female cancer I had to BEG to get the cancer removed, 6 months, After I was told BCBS would no longer cover cancer in me again .
May 7th, 2009 at 2:46 pm
It’s definitely not greedy doctors. The dollar amounts on my doctor paycheck haven’t changed in 15 years. If you count inflation, I make significantly less than I did in the past. The money is in the system somewhere. Your doctor isn’t getting it however.
May 8th, 2009 at 1:12 pm
You contact a local, independent agent in NC. They'll be able to give you a 'ball park". HOWEVER, if you're under 30 and healthy, it's going to cost about $200 a month. If you have problems, you're likely not going to be insurable, depending on their seriousness. Or it could cost you $500 a month.
May 8th, 2009 at 1:21 pm
Health insurance can be very tricky. Since I live in Utah I'm not sure about Florida laws and regulations, so I suggest you contact a nearby insurance agent. http://www.goodinternetdeals.com/Health-Insurance.html They will be able to assist you.