Individual Health Insurance
Individual health insurance is coverage that consumers purchase for themselves or for their families. Even if your employer offers some sort of coverage, an individual plan still might be the right option for you. With so many options to choose from, you are empowered to find a plan that suits your specific health care needs.
When it comes to choosing a plan, both price and level of benefits need to be seriously considered. An individual health insurance may be more affordable than you think. See for yourself by comparing health insurance quotes from the nation’s top carriers right now.
There are plenty of individual health insurance plans to choose from. Here are the most common types:
- HMOs (Health Maintenance Organization). HMOs are one of the most affordable health plans available — and they offer comprehensive coverage. HMOs create networks of doctors, hospitals, clinics, specialists, and other care providers. Most HMO networks consist of thousands of health industry professionals, ensuring you’ll have convenient access to medical care when you need it.
- PPOs (Preferred Provider Organization) . The PPO is an affordable individual plan with an added benefit — you’ll have coverage with any health care provider. That means you can see any doctor or specialist you want, and your plan will cover the care. The PPO is great for flexible, comprehensive, and affordable care.
- Health Savings Account (HSA). An HSA is opened in conjunction with a high-deductible plan. This tax-free savings account allow you to save money to pay for routine medical expenses.
- Fee For Service (FFS) Plans. The FFS plan is the traditional form of individual health insurance. It works very simply — you get the care you need, then you’re reimbursed for a percentage of the cost.
Paying for Affordable Health Insurance – The Basics
Here are some terms you should become familiar with before deciding on your new individual coverage:
- Premiums. This is cost of keeping your plan in effect. Premiums are usually paid on a monthly basis. When you’re looking at plan premiums, keep in mind that what you’re seeing is a base price for the plan. Your premium could be adjusted based on your age and health status. Insurance companies call this “rating.” People who lead healthier lifestyles get more affordable health insurance premiums.
- Deductible. This is the amount you’ll have to pay before your plan starts picking up the rest of the bill. A deductible can range from a few hundred dollars to several thousand dollars. And a lower deductible isn’t always better — higher deductibles mean lower premiums. Ask yourself: would you prefer to pay more for your monthly insurance bill, or when you receive care?
- Copayments and Coinsurance. These are charges you’ll have to pay for any specific medical service you receive. Copayments are fixed amounts — for example, a “$20 per Office Visit” means you’ll pay $20 out of your own pocket for a routine trip to the doctor. Coinsurance is a similar cost, but expressed as a percentage — “20% of Non-Emergency Hospital Care,” for example. Typically, affordable health insurance copayments and coinsurance run about $20 and 20%, respectively.
- Out-of-Pocket Maximums. Between your deductible, your copayments, and your coinsurance costs, staying healthy can be expensive. That’s why health plans include out-of-pocket maximums, to keep your care affordable. Once you reach your out-of-pocket maximum, most health insurance plans will pick up 100% of the rest of your costs (though some plans have exceptions to this – see below).
Individual vs. Employer-Sponsored Health Coverage
Why choose an individual plan over an employer’s plan? Here are the key advantages of individual health insurance:
- Customized coverage. In group coverage, everyone ends up in a one-size-fits-all type of plan. But everyone has different health needs. With employer-sponsored coverage you end up paying for coverage you don’t need, or may have to go without coverage for care you do need.
- Mobile coverage. With an employer’s plan, leaving your job means leaving your health insurance. Individual plans protect your health wherever your career takes you.
Which Individual Health Insurance Plan Is Right For Me?
If you’re a person who is in good health, you might want to consider a high-deductible PPO that’s compatible with a Health Savings Account. This option is best for people who don’t visit the doctor often, and are looking for major medical coverage.
If you’d rather have more comprehensive individual health insurance coverage, such as preventive care coverage, consider a PPO or HMO plan with a lower deductible. You might not be able to use an HSA, but you’ll have coverage for routine doctor’s office visits and other preventive care. Typically, you’ll pay between $10 and $40 for a doctor’s office copayment depending on your plan. With this type of plan, you’ll also have major medical coverage.
GoHealth can help answer any questions you may have about your coverage options. Get free quotes and get expert advice from a professional agent.