If you are self-employed or there is no group medical benefit offered by your employer you will want to look for a health plan for individuals. You can select a plan to cover only you and either or both of your spouse and children.
There are diverse health covers now available from providers to match different customers’ needs, but selecting a satisfactory plan for you and your family at a reasonable price poses some difficulty. We can take a look at the main health insurance plans that are available today.
- Preferred Provider Organization (PPO) – PPO health plans have are quite popular as they include a network of providers of medical services that help to control costs, but still do allow their clients to get service outside the network on some instances if they are willing to receive reduced cover. In emergency situations you do get full network coverage even when seeking medical attention from outside the network.
Where a particular service is not available within the network, you may still get the need covered at network rates. However, to get such service, prior authorization for the service must be obtained.
- Health Maintenance Organization (HMO) – An HMO has what is called managed care. The health insurance provider manages costs by covering health care through a network. They will of course make exceptions in cases of emergency or where the service needed is not available within the selected network.
- Health Savings Account (HSA) – The HSA plan comes in two sections. One is a medical plan with a high deductible and a savings account for the second part. Within limits, you may be able to deduct these contributions from the tax liability and the savings can accrue interest and the balance at year-end can be rolled. To control costs, the high deductible plan can be allied with a PPO network.
- Indemnity Health Insurance – This is the old style insurance health plan that just provides health insurance cover for amounts based on the deductible and up to the maximum allowed for that policy.
- Mini Med Plan or Specified Benefit Plan – For each medical service that is covered, the plan specifies the benefit amounts payable. The premium due on each policy is in general lower than that for major plans, but equally, the maximum benefits payable also tend to be much lower than for the majors.
Which plan then will suit your needs? You need to assess your needs, budget and expectations. There is no point in taking out a health insurance plan you can not afford.
You may decide on a higher premium or settle for higher cost sharing than you want to reduce premiums. For an individual, the type of covers available differ considerably from those provided through an employer.
You may find that an HMO network near you can provide you with the health care at an affordable cost. You may however prefer the flexibility provided by a PPO which does not require that all medical care is availed through a medical provider network. For the good savers, the HSA plan may fit them better as it gives them control over the management of costs.
Source by Jack Adams
