Think about choosing health insurance like buying a pair of jeans: In a clothing store, there are usually dozens of racks of jeans to choose from. As you shop, you consider what kind of jeans you want, along with how much you want to spend. You look at the options that fit your criteria and try them on to see which fits best.
Now imagine each rack is a different insurance company. You can shop in the same way — by comparing various types of plans, comparing rates, and comparing coverage and benefits. When you shop smart, you will find the best fit for your health needs.
I will help you with the shopping by showing you the options, and together we will sort out the details and see which plan fits you best.
Individual Health Insurance
Until recently, most people obtained their health insurance from their employer, and people with low income got their insurance from the government. But now, more and more people are buying private health insurance plans tailor-made for individuals.
Individual health insurance is actually more affordable than you think. We can help you compare rates from leading health insurance carriers to see for yourself.
First, here are a few basics about individual health insurance:
What Kinds of Private Health Plans Are Available To Me?
There are plenty of individual health 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 healthcare professionals, ensuring you’ll have convenient access to medical care when you need it.
PPOs (Preferred Provider Organization)
The PPO is an affordable health 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 health care.
HSA (Health Savings Account)
There are 2 parts to HSA coverage: a high-deductible plan and a Health Savings Account. The high-deductible plan provides catastrophic coverage and features low monthly premiums. The HSA is a tax-free savings account where you save money to pay for routine medical expenses.
FFS (Fee For Service)
The FFS plan is the traditional form of health insurance. It works very simply — you get the care you need, then you’re reimbursed for a percentage of the cost.
Understanding The Terms Of Your Personal Health Insurance Plan
Premiums
Your premiums are payments you make to keep your plan in effect. Usually, premiums are paid each month. Premiums are set by your insurance company based on factors such as health status, age, where you live, and where you work.
Deductible
The deductible is the dollar amount you’ll be responsible for before your plan begins coverage. Most health plans let you choose your own deductible, so how do you choose the amount that’s best? It might seem like a lower deductible would be better, but a low deductible means you’ll have to pay higher monthly premiums. It works the other way too — the higher your deductible, the lower your monthly bill. You’ll have to decide if you want lower monthly premiums or lower medical bills for your health care.
Copayments and coinsurance
If you have an HMO, you might pay $15 at the doctor’s office for a check-up. That’s called your copayment. You pay a certain dollar amount of the bill and your plan covers the rest. HMOs offer copayments as low as $10, while PPOs often charge copayments of $40 or less. Coinsurance is similar to a copayment, except it’s expressed as a percentage rather than a dollar amount. A coinsurance rate of 80/20 means you’ll be responsible for 20% of a medical bill.
Individual vs. Employer-Sponsored Health Coverage
The majority of people have employer-sponsored health insurance. But the number of people with individual coverage is growing. Today, more than 13 million people have an individual plan.
Why choose an individual health 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.
Medicare Advantage
"We do not offer every plan available in your area. Currently we represent 3 organizations which offer 20 products in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program to get information on all of your options.’’
Medicare Advantage
“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”
Medicare covers many of your health care needs. Today’s Medicare is working with private companies approved by Medicare that provide different ways to get your healthcare and prescription drug coverage in the Medicare Program. The Medicare plan that you choose affects many things like cost, benefits, doctor choice, convenience, and quality. Your Medicare plan choices include:
The Original Medicare Plan
This is a fee-for-service plan that covers many healthcare services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue Medicare card. The Original Medicare Plan pays for many healthcare services and supplies, but it doesn’t pay all of your healthcare costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.
Medicare Advantage Plans – Available in many areas
If you have one of these plans, you don't need a Medigap policy. These plans include:
Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, Medicare Special Needs Plans, and Medicare Medical Savings Account Plans (MSA)
These plans may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drugs. In some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals to get covered services. Call or email for more information on Medicare Advantage Plans.
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