Health coverage for an individual is relatively easy to plan because there is only one person to consider. For this person, there are two major categories of health insurance available: group and individual. Most people try to save money by buying a group policy.
Group plans use several types of medical networks and it will help you to learn about each: HMOs, PPOs,POSs, and new Health Savings Accounts. The different characteristics of each network can affect which group insurance you ultimately choose.
Group plans use several types of medical networks and it will help you to learn about each: HMOs, PPOs,POSs, and new Health Savings Accounts. The different characteristics of each network can affect which group insurance you ultimately choose.
Which plan is right for me?
An HMO needs to be close to your home or work because it is where you are required to see your primary care physician. It is sometimes slightly less expensive. The PPOs and POSs cover wider geographic areas. They encourage you to see doctors within their networks but you also have freedom to seek care from out-of-network physicians. They are sometimes slightly more expensive than an HMO, but you might want their flexibility.
The Health Savings Accounts work in combination with a high deductible health policy which is cheaper. Money saved with the lower premium is put into the savings account for medical fees and can earn tax-free interest if not used. More details about the above types of group health insurance networks are contained both in the Glossary and elsewhere in this website.
How can I lower my insurance expenses?
There is one single item which creates the most variation in the cost of a policy and that is the deductible. The amount of the deductible can be changed where the higher the deductible, the lower the premium and vice versa. Other coverages affect the cost of the premium also. Options added to some plans will, of course, raise the premium. Determine your true health needs because some options might not be necessary. Do spend money, however, to ensure your maximum coverage on each claim and maximum coverage over your lifetime are at recommended levels.
Individual Insurance
People also have the choice of buying individual health insurance, although it costs more. When buying individual insurance, the policy is written solely for that person, based on his/her personal medical conditions. If there is a pre-existing condition, it can make buying individual insurance difficult. Whether a person is accepted for insurance is very unpredictable at times. It may help to know that a person may be accepted for comprehensive insurance, excluding the pre-existing condition. One thing which affects the cost of individual health insurance is smoking—smokers always pay more.
In order to target the best insurance at the best price for yourself, consider the following guidelines:
- Individuals usually buy group health insurance because it is less costly.
- It will help you to learn about the various networks associated with the different types of group insurance (HMOs, PPOs, POSs, and Health Savings Accounts).
- Raising your deductible will always lower your premium.
- When you have narrowed your choice to two group insurance policies, compare the following of both: premiums, co-payments, deductibles, speculated out-of-pocket expenses, percentages of fees paid, maximum limits on each claim and on lifetime claims. It will help to make a chart.
- If you have less than perfect health, you may not be accepted for individual coverage.