Find The Best Personal Health Insurance Online

Milliman USA expects healthcare insurance rates to increase 14 percent in 2004, the third year of double-digit increases. Meanwhile, employers are cutting medical insurance benefits and passing higher costs onto their workers.

It might be time for you to seriously review you and your loved ones’ healthcare options. Great values on superior healthcare insurance coverage are available if you know where to look. Request a quote today.

What is individual healthcare insurance?

• Individual healthcare insurance is coverage purchased by an individual, as opposed to a group (business or union), directly from an insurance company. Good candidates are uninsured part-time workers and self-employed individuals without access to a group plan through an employer, union, or spouse.
• Though group healthcare plans are technically more expensive than individual healthcare insurance plans, individual policies will generally cost more than what a person pays for group coverage. Why? Because the employer is paying a large portion of the group plan’s premium, if not all of it, as a benefit to the employee. (Before buying an individual healthcare policy, see if you belong to any associations that offer group health.)
• Be aware that insurance companies are not obligated to sell healthcare to individuals that don’t meet specific state or federal requirements. Also, even if you do meet requirements, you may be deemed a bad risk and given lower benefits. Once you do have a policy, however, an insurer cannot cancel it if you get sick. The policy is guaranteed renewable if you pay your premium.
  Eligible individuals can opt for an indemnity (fee-for-service) plan or a managed care solution, such as an HMO, PPO, and POS plan. Here is a review of fee-for-service and the primary managed care plans.
• Indemnity: This is the most flexible, yet expensive healthcare insurance option. Policyholders select the doctor of their choice and pay as they receive services. The patient or doctor then submits a claim to the patient’s insurer for reimbursement, minus a negotiated deductible. The patient is reimbursed for “covered” medical expenses, listed in the plan’s benefits summary. Generally, the insurer pays 80 percent of the “reasonable and customary charge,” while the patient pays a 20 percent coinsurance. Lifetime benefit limits also are set, usually at $1 million.
• Managed Care: These healthcare insurance plans provide comprehensive health service at a lower cost, yet limit physician choice. Coverage also is paid in advance, instead of per visit or service.

There are three popular types of managed or prepaid care: HMO, PPO, and POS.

• Health Maintenance Organization (HMO): Patients pay a monthly or quarterly premium, whether they use the plan’s services or not, but usually no deductibles or coinsurance. Modest co-payments are required for specific services, such as office visits and prescriptions. The upside: your medical care requires few out-of-pocket expenses. The downside: you are limited to doctors in the HMO network. Also, services by specialists are not always covered, even when approved by your primary care physician.
• Preferred Provider Organization (PPO): These plans can be more costly than HMOs, but they also are more flexible, combining features of managed care and fee-for-service. In short, they will pay some reimbursement for covered services provided by doctors outside the plan. HMOs generally do not.
• Point-of-Service Plan (POS): PPO and POS plans are the same, except POS plans have primary care physicians. PPO plans do not.

Be aware that managed care plans evaluate if physician-recommended services are medically necessary. This is known as a utilization review. If you don’t want to risk denial of service, indemnity plans may be the better option. Also, note that managed care plans use discharge planning to reduce expenses. Patients that don’t require hospitalization are often transferred to more cost-effective units, such as nursing facilities.

Benefits Of Individual Healthcare Insurance

• Individuals can select the healthcare insurance company and plan that is right for them and their families, from flexible fee-for-service plans to comprehensive, economical managed care solutions.
• Individual healthcare plans, unlike group plans from an employer or association, can be more easily tailored to meet policyholder needs.
• Obtain dental coverage and a prescription drug benefit in one policy.

The In’s And Out’s Of Personal Healthcare Insurance

• Use the Internet to compare individual healthcare insurance plans and request medical insurance quotes. Often costs for similar policies from different providers will vary.
• When comparing healthcare insurance policies, consider what medical services are covered, what benefits are paid, and how much you must pay in deductibles and co-insurance. Also review exclusions, such as if preexisting conditions are exempt. (If the policy “Exclusions” section is short, look for limitations throughout the policy.)
• Select an insurer with an excellent financial rating, who can be trusted to pay its claims, graded “A” to “AAA” by companies like A.M. Best and Standard & Poor’s.
• Lower your risk to potential insurers by being serious about your healthcare and nutrition. Watch your weight, lower your blood pressure and cholesterol, and stop smoking.
• Lower premiums by increasing your deductible.