Individual Health Insurance

Individual health insurance is a type of health insurance coverage that is made available to individuals, rather than to employer groups or organizations. When you are planning to buy individual health insurance you will find out multiple rate quotes from different companies. Price is really confusing in individual health insurance market. For example, premium for similar product from different insurers can vary upto 50 percent for the same person. Other things like rules and regulations in individual health insurance vary from sate to state. When selecting individual health insurance you have to keep two things in mind - right balance of coverage and cost, as well as philosophy of care.

Individual health insurance also called as family health insurance are generally divided into two- indemnity health plans and managed care health plans. There are several types of managed care health insurance plans. These include Health Maintenance organization (HMO), Preferred Provider Organization (PPO) and point of service (POS) plans. In Managed care plans you'll have less paperwork and lower out-of-pocket costs.

Health Maintenance Organizations (HMOs): are one of many types of managed care arrangements. It is also called as "pure" managed care. In this plan you have to pay certain monthly insurance fee. Individuals who join a HMO are considered members. Members can choose a Primary care physician from the HMO list provided to him. HMOs have a network of physicians and hospitals and require members to assign a primary care physician. Primary Care Physician will provide its members health care needs. You have to make certain co-payments each time you visit a doctor. If a member needs a specialist, Primary care physician will refer the member to the specialist who is also in the HMO network. If members receive service out of network they have to pay all the expenses out-of-their-pockets.

Preferred Provider Organization (PPO): A PPO is somewhat similar to HMO. PPOs encourage members to utilize the doctors and hospitals within the network but do allow members to visit out-of-network medical service providers. PPO members have to pay both co-payment and deductible for in-network coverage. If members go out-of-network for their medical needs, they are still covered to a certain degree.

Point of Service (POS): POS plan combines both HMOs and PPOs. If members visit physicians within the network they don't have to pay any deductible and limited co-payments. Similar to PPO, Point of service plans also offer limited coverage to members who choose to go out-of-network for medical care.

Indemnity plans: An indemnity plan gives more freedom to its members than managed care plans. In this plan, they can visit doctor of their choice. There is no network of physicians involved in an indemnity plan and no restrictions. But, this plan is more expensive than managed care plans and involve more out-of-pocket expenses.

When you are selecting a health plan, remember than each plan functions differently from the next. However, only you can determine what type of medical plan best fits your health needs.


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