subject: Acquiring An Individual Medical Plan [print this page] Acquiring an individual medical plan Acquiring an individual medical plan
Purchasing a private health care insurance plan can be daunting for those who have always been insured by their company's group insurance.
The 3 things you should focus on are price, coverage and the quality of the company. When you uncover a insurance contract that is good in all three areas, you you should strongly consider it.
Your health insurance company should be financially stable and have a good record for paying claims. Claims paying ability is, of course, important.
Coverage - The health care coverage must meet your needs. It should cover doctors, hospitals, labs and drugs. It should also have physicians and hospitals in their networks that are close to you.
Price- Your health care plan must be priced competitively relative to the coverage provided. Cost is important, but benefits are just as critical.
The basic process you should use is to: Determine which private medical companies are worthy of being considered. Determine which plans offered by those health care companies offer adequate coverages.
Determine which plans are priced best relative to the health insurance coverages provided
A private medical insurance company should have good AM Best ratings and be in good standing with your states insurance department. You may also want to do a Yahoo! search for complaints.
For example search for "Mega Insurance complaints" before buying a plan of insurance from them. All medical insurance company has some unhappy customers just by virtue of the volume of clients they have. That being said, a red flag should go up in your mind if the complaints are too numerous.
One more issue to be concerned with is how much they pay in benefits as a percentage of the premium they take in. A typical company will write checks for about 80% of the money they take in to pay for their policy holders' doctors and hospital bills.
Coverage - What does your health insurance plan cover? There are two important parts of coverage. One is the procedures that are covered. The other is the networks list of hospitals and doctors that the insurance contract includes.
Your medical policy should cover you well and the hospital and should have a good lifetime maximum benefit. I suggest at least five million dollars of coverage. You should read through your insurance plans outline of coverage or official brochure to see how doctors, hospitals and prescriptions are covered.
Health care Insurance Exclusions and Limitations
Most if not all health care insurance policies will have a list of procedures and services that are not covered. Most of the items in this section are reasonable and are included in the plans of most carriers also. Plans typically won't cover cosmetic surgery for example. There are are often exclusions that you might find in one company's plan but not in others. Coverage for preexisting conditions is one example of this. Generally plans will not cover the costs of a child birth. The ones that do tend to cost more when compared to otherwise similar plans that dont cover pregnancy. The exclusions and limitations section of your policy or its out line of coverage should be read carefully before you commit to purchasing any health insurance plan.
Medical Insurance Provider Lists
Knowing which physicians and hospitals are in your health insurance carrier's network is important for obvious reasons. You should be able to find a list of doctors who accept a given insurance plan on the Internet or by calling your health care insurance broker.
Cost Locating the best low cost medical plan
It is easy to compare individual health insurance prices, but it is more difficult to be certain that you are getting good coverage for your dollars.
Not until you have crossed the plans on your list that have bad benefits and/or a lousy network of doctors and hospitals should you start comparing the prices of the policies
The best health insurance coverage, may not be the best contract for you. Often the best policy is overpriced and does not offer coverage that justifies the extra that it costs. Make sure that any plan you buy is:
Provided by a good health insurance carrier. It should also cover your healthcare needs well. It should also be affordable.
