Personal Health Care Insurance: Explore All Your Options


Personal Health Care Insurance: Explore All Your Options
Personal Health Care Insurance: Explore All Your Options

Personal Health Care Insurance: Explore All YourOptions

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Personal health insurance is available in many variations; while good coverage will probably not be quite as cheap as group coverage, you still should be able to find something affordable that will protect you from the extreme costs of having no coverage at all.

Federal laws protect those who have had group coverage

If you have had group coverage for the past 63 days, you are entitled under a federal act referred to simply as COBRA to keep your group coverage and pay it yourself for up to 18 months. This period is extended to 3 years if you are disabled. Be prepared for a much higher cost than you are accustomed to, however, as your employer will no longer be sharing the premium with you.

Another federal act referred to as HIPPA says that no company can turn you down, regardless of your health if you have not been without group coverage for more than 63 days. HIPPA does not, however, control the premium for the coverage. If a company doesn't want to cover you, they can simply charge you a premium you can't possibly afford.

Coverage varies according to the plan a company offers

Under group coverage, you may have had few choices, and therefore may not be aware of the many variations of coverage. Generally speaking, you have indemnity plans also called "fee for service," and managed care plans called HMOs.

The indemnity plan is traditional insurance. You go to a doctor of your choice; he charges a fee for his service and you pay a part of it, called a co-pay. The insurance pays the remainder according to a schedule of "usual and customary" rates which vary from place to place.

The opposite of the fee for service is the HMO. In this type of plan, you have a primary care doctor and cannot see any other doctor without a referral from the primary provider. Many people do not like the restrictions of the HMO, but these plans are usually more affordable than traditional coverage. They do not, however, guarantee any better coverage than a traditional plan.

A third type of plan that blends traditional insurance with the HMO is the PPO, or Preferred Provider Organization. In these plans, you can see any doctor in the network without a referral from a primary care physician. You can also go outside the network, but will pay a higher copay, and you may even have a separate deductible.

Finally, there are some catastrophic coverage plans that do not pay for doctor visits at all, but only pay if you are admitted to a hospital. Some plans which are not considered "catastrophic" simply have such a high deductible that you are not likely to use the insurance unless you do have an accident or major illness. These plans will usually be a cheap alternative.

Finding the best plan for yourself

Unfortunately there is no standard personal health insurance plan; the only way to find the one that is right for you is to consider your current health, the risks you are able and willing to take, and look for a plan that will provide health coverage at a price you are willing to pay. Usually, a knowledgeable agent can help you understand the terms of any company policy.