Finding the Right Health Insurance as an Individual
Finding health insurance as an individual can be daunting. There are so many types of coverage and so many different factors that can affect your rates that it is often hard to choose the right health insurance policy for yourself. Factors such as current medical history, family history, smoking and preexisting health conditions will determine whether you will be paying higher rates or even your eligibility for coverage.
For most people, there are basically two types of individual health insurance coverage. Fee for service coverage is fairly straightforward. You can visit any doctor you want with fee for service coverage and once the visit is over either you or your doctor will then file a claim. If your deductible has been met then you will pay a percentage of the doctor bill while the insurance company covers the rest. It is slightly different if your deductible is not met because you will typically pay the full amount to the doctor and send in a claim to the insurance company showing the paid amount, which will be credited to your deductible. Once your deductible is met, your insurance will take over, subject to whatever restrictions your policy carries. This type of policy offers the most flexibility in terms of selecting health care providers, but it is also the most costly
For those who want less hassle and paperwork there is always managed care coverage. Managed care health insurance are your Participating Provider Organization (PPO) and Health Maintenance Organization (HMO) coverages. In a many ways, PPOs and HMOs are similar. With a PPO you can expect to have a deductible as well as a co-payment but with an HMO, you will have a co-payment but very rarely a deductible. A typical PPO will have a higher co-payment requirement than a typical HMO. Although both types of insurances use preferred service providers (or in-network providers), the way they handle service providers outside their networks differs. Under a PPO, you can see people outside of their preferred providers network, it will just cost you more. With an HMO if you go to see an out-of-network service provider you will pay 100% of the bill, unless you have approval to use the non-network provider (usually a specialist). Even then, you would pay the portion of the bill that is over and above the HMO s rate schedule. Basically you have more flexibility with a PPO than you do with HMOs.
Finding health care coverage for an individual is time consuming and can be frustrating, but armed with the proper information you can make an informed decision and find the individual health care coverage that is right for you.
Denise Durbin is the webmaster for HealthInsuranceFAQs.com Before you buy a health insurance policy, visit http://www.HealthInsuranceFAQs.com for health insurance shopping tips.
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