| Once upon a time nearly everyone received | | | | coverage plans |
| health care coverage through employer group | | | | Once you are more familiar with the language of |
| health plans, but these days many are turning to | | | | health insurance, you will want to familiarize |
| individual medical coverage to ensure they have | | | | yourself with the different individual medical plans |
| access to the medical services they need. Issues | | | | offered. |
| such as unemployment, self-employment and | | | | These are the most common: |
| companies cutting-out group health benefits are | | | | * HMO-Standing for Health Maintenance |
| requiring people to brush up on their insurance | | | | Organizations, HMOs are designed to be a more |
| knowledge so they can make the best decisions | | | | affordable health insurance coverage. They |
| for themselves and their dependents. | | | | provide comprehensive medical coverage through |
| With medical costs increasing, it is more important | | | | a network of hospitals, doctors, clinics and health |
| than ever to have the right coverage to meet | | | | care professionals. If you have a particular doctor |
| medical needs. When you are in charge of | | | | or hospital you prefer, it is important to make |
| selecting your individual medical coverage, how | | | | sure they are included in the HMO network, as |
| can you know if the plan is right for you? And is | | | | these types of individual plans are quite costly if |
| it even possible to find affordable health coverage | | | | you go outside of the network for care. |
| outside of an employer group health plan? | | | | * PPO-Standing for Preferred Provider |
| It is worth your time to wade through the | | | | Organizations, PPOs are different from HMOs in |
| information to determine what individual medical | | | | that you can have coverage from a variety of |
| coverage is best for you and your budget. To | | | | different doctors and specialists without referrals. |
| make it easier for you, below is a compilation of | | | | Still, there is typically a PPO network of doctors |
| the information you need to make solid decisions | | | | and hospitals that offer you more coverage, but |
| about your coverage choice. | | | | you have the freedom to choose outside of the |
| Breaking down the insurance lingo | | | | network and receive partial coverage. |
| While some of the insurance terms may be | | | | * FFS-Standing for Fee for Service, the FFS plan, |
| familiar to you, others may seem like part of a | | | | also known as indemnity insurance, is a very |
| foreign language. Here are some terms you will | | | | simple, straight forward individual medical |
| likely need to know: | | | | coverage through which you obtain the medical |
| * Premiums-this is the money you pay to receive | | | | care you need from any doctor, hospital or health |
| individual medical coverage. You may pay it | | | | care professional, pay for the fees yourself, and |
| monthly or yearly. Insurance companies base the | | | | then receive a reimbursement for a specific |
| amount of your premium on factors including age, | | | | percentage of what you paid. This is not a |
| level of health, medical history, lifestyle and | | | | comprehensive plan and it does not cover |
| occupation. | | | | preventative care, but is one option for an |
| * Deductible-this is the money you will have to | | | | individual who does not plan to receive a lot of |
| pay out of your own pocket prior to your medical | | | | medical care and cannot afford higher premiums. |
| coverage kicking in. Typically, you can select your | | | | * HSA-Standing for Health Savings Account, the |
| deductible to fit your medical and financial situation. | | | | HSA account offers coverage that works as a |
| For example, a lower deductible requires a higher | | | | catastrophic medical plan with a high-deductible |
| premium, while a higher deductible will allow you to | | | | and lower premiums. The account also includes a |
| keep your premiums low. Still, a high deductible | | | | savings account that is tax-free and allows you to |
| isn't always best if you know you will be using | | | | save money to pay for the more routine medical |
| medical services often. | | | | care yourself. |
| * Coinsurance-this is a percentage of the medical | | | | Conducting a thorough health insurance plans |
| bill that you will pay. For example, some medical | | | | comparison is a wise way to choose the best plan |
| plans will offer a coinsurance rate of 75/25, which | | | | to meet your needs. It makes good sense to |
| means you will pay 25% of the medical costs | | | | research the plans, so you are fully aware of the |
| while the insurance will pick up the other 75%. | | | | cost and coverage and know what to expect. |
| Understanding the types of individual medical | | | | |