What Kinds of Private Health Plans Can I Choose From?

There are plenty of individual health insurance plans to choose from. Here are the most common types:

• HMOs (Health Maintenance Organization). HMOs are one of the most affordable health plans available — and they offer comprehensive coverage. HMOs create networks of doctors, hospitals, clinics, specialists, and other care providers. Most HMO networks consist of thousands of health care professionals, ensuring you'll have convenient access to medical care when you need it.
• PPOs (Preferred Provider Organization). The PPO is an affordable individual health insurance plan with an added benefit — you'll have coverage with any health care provider. That means you can see any doctor or specialist you want, and your plan will cover the care. The PPO is great for flexible, comprehensive, and affordable health care.
• Health Savings Account (HSA) Plans. There are 2 parts to HSA coverage: a high-deductible plan and a Health Savings Account. The high-deductible plan provides catastrophic coverage and features low monthly premiums. The HSA is a tax-free savings account where you save money to pay for routine medical expenses.
• Reimbursement Plans. The reimbursement plan is the traditional form of individual health insurance. It works very simply — you get the care you need, then you're reimbursed for a percentage of the cost.

Understanding the Cost of Personal Health Insurance Plans

Which health plan costs do you need to know about your individual health insurance plan?

Your premiums
Your premiums are payments you make to keep your plan in effect. Usually, premiums are paid each month. Premiums are set by your insurance company based on factors such as health status, age, where you live, and where you work.

Your deductible
The deductible is the dollar amount you'll be responsible for before your plan begins coverage. Most individual health insurance plans let you choose your own deductible, so how do you choose the amount that's best?

It might seem like a lower deductible would be better. But a low deductible means you'll have to pay higher monthly premiums. It works the other way too — the higher your deductible, the lower your month's bills. You'll have to decide if you want lower monthly premiums or lower medical bills for your health care.

Copayments and coinsurance
If you have an individual HMO, you might pay $15 at the doctor's office for a check-up. That's called your copayment. You pay a certain dollar amount of the bill and your plan covers the rest. HMOs offer copayments as low as $10, while individual PPOs often charge copayments of $40 or less.

Coinsurance is similar to a copayment, except it's expressed as a percentage rather than a dollar amount. A coinsurance rate of 80/20 means you'll be responsible for 20% of a medical bill.

Individual vs. Employer-Sponsored Health Coverage

The majority of people have employer-sponsored health insurance. But the number of people with individual health insurance coverage is growing. Today, more than 13 million people have an individual plan.

Why choose an individual plan over an employer's plan? Here are the key advantages of individual health insurance:

• Customized coverage. In group coverage, everyone ends up in a one-size-fits-all type of plan. But everyone has different health needs. With employer-sponsored coverage you end up paying for coverage you don't need, or may have to go without coverage for care you do need.
• Mobile coverage. With an employer's plan, leaving your job means leaving your health insurance. Individual plans protect your health wherever your career takes you.

Which Individual Health Insurance Plan Is Right For Me?

As you look for an individual plan, you might be asking yourself: What plan is right for me? Which plan do people like me choose?
If you're a person who is in good health, you might want to consider a high-deductible PPO that's compatible with a Health Savings Account. This option is best for people who don't visit the doctor often, and are looking for major medical coverage.

If you'd rather have more comprehensive individual health insurance coverage, such as preventive care coverage, consider a PPO or HMO plan with a lower deductible. You might not be able to use an HSA, but you'll have coverage for routine doctor's office visits and other preventive care. Typically, you'll pay between $10 and $40 for a doctor's office copayment depending on your plan. With this type of plan, you'll also have major medical coverage.

Even if neither suggestion seems right for you, there plenty more options to choose. What's the best way to find out which individual health insurance plan is right for you?

Contact a professional at Hagan Newkirk to get no-cost, no-hassle, expert advice from a professional.