Get Individual Health Insurance Quotes to find an affordable health coverage option
Individual health insurance quotes can be your option for health care coverage if you are self-employed or without an employer-based health plan.
There are many plans available for you to choice from, but be aware that the qualifications for coverage under an individual plan can be more stringent than with a group plan. Also when applying for coverage, it is wise to disclose your complete medical history so as not be denied a claim when you need to be covered most.
Know your needs to get the best plan for you
When shopping for individual health insurance, know your needs so you get a policy that is right for you. Know your level of managed risk. Decide how much debt you can manage should you become seriously ill and consider opting for a high-deductible policy.
Be aware that insurance companies are not obligated to sell healthcare to individuals that don't meet specific state or federal requirements. Additionally, even if you do meet their requirements you may be deemed a “bad risk” and given lower benefits. Once you do have a policy, however, an insurer cannot cancel it if you get sick. The policy is guaranteed renewable if you pay your premium.
On the positive side, Individual healthcare plans, unlike group plans from an employer or association, can be more easily tailored to meet policyholder needs.
Two Types of Plans
Eligible individuals can opt for an indemnity (fee-for-service) plan or a managed care solution. Types of managed care solutions include HMO, PPO, and POS plans.
Both indemnity/fee-for-service plans and managed care plans cover various medical, surgical, and hospital expenses. Many also offer a prescription-drug and dental-care benefit. However, there are some important differences between indemnity/fee-for-service and managed care plans:
Indemnity/Fee-for-service: This is the most flexible and the most expensive option. Policyholders select the doctor of their choice and pay each time they receive services. You or your doctor then submit a claim to your insurance company for reimbursement, minus a negotiated deductible. You are reimbursed for the "covered" medical expenses listed in the plan's benefits summary. Generally, your insurance company pays 80 percent of the "reasonable and customary charge," while you pay a 20 percent coinsurance. Lifetime benefit limits also are set, usually at $1 million.
Managed Care: These plans provide comprehensive health services at a lower cost, but your choice of doctors is limited. You must pay for your coverage in advance, instead of per visit or service.
There are three popular types of managed or prepaid care: HMO, PPO, and POS. For more detail, see Individual Healthcare or Group Health.
Health Maintenance Organization (HMO): Patients pay a monthly or quarterly premium, whether they use the plan's services or not (but usually no deductibles or coinsurance). Modest co-payments are required for specific services, such as office visits and prescriptions. The upside: your medical care requires few out-of-pocket expenses. The downside: you are limited to doctors in your HMO network. Also, services by specialists are not always covered, even when approved by your primary care physician.
Preferred Provider Organization (PPO): These plans can be more costly than HMOs, but they also are more flexible, combining features of managed care and fee-for-service. In short, they will pay some reimbursement for covered services provided by doctors outside the plan. HMOs generally do not cover fees for doctors outside of your HMO netowork.
Point-of-Service Plan (POS): PPO and POS plans are the same, except POS plans have primary care physicians. PPO plans do not.
