subject: Options To Consider When Buying Your Own Health Care [print this page] When it comes to health insurance, it is a nice benefit when someone else is footing most of the bill. Unfortunately, this is typically reserved for people who work full-time for their employer. People who work part-time, are self-employed or who are attending college are faced with the option of finding their own health care coverage. In today's society, when one unplanned illness or injury without health insurance can lead to bankruptcy, it is a necessity to have. In can also be overwhelming for health care consumers to know how to select the best policy.
Individual health insurance plan considerations is a big concern for most people in the market for health insurance and this is especially true if they are purchasing their own because cost is a huge issue. As important as this factor is, there is another factor that is equally or even more important; what you are getting for what you are paying. You cannot determine the value of a policy based solely on the price tag, even if it is identical to other policies because the coverage and options will have some major differences. Because of these factors, doing your homework and research is even more important before you ever put on your buying hat and make a decision.
A HMO, or Health Maintenance Organization plan is considered to be the most common type of coverage plan available in today's health care coverage market. A HMO is a network of doctors, hospitals, pharmacists and many other health care providers that agree to accept a person's insurance when services are rendered. It is the choice of the individual to choose a primary care physician and clinic from the list of professional participants and these primary providers are always the first stop before seeking or being referred to other specialists for treatment. Many HMOs also require a referral form from the primary provider before they will dispense any benefits payments for services.
People who do not wish to be covered by an HMO will need to inquire about other options with their potential insurance company. Some of these may included a Preferred Provider Organization (PPO) or a self-directed plan.
Deductibles and Co-Insurance. Most self-insured plans require payment of a deductible before any benefits are paid on the plan. The lower the deductible, the higher the monthly premium payment will be. Deductibles can range anywhere from $500 to $10,000 or more. People who opt for high-deductible insurance plans may also choose to open a health savings account (HSA) to set aside money on a pre-tax basis for qualified medical expenses. Co-insurance refers to the amount the plan pays verses the amount the participant pays. An 80/20 split is common.
