Need to Know Information When Considering Personal Health Insurance

Tuesday, July 17, 2012

Need to Know Information When Considering Personal Health Insurance

For most people out there, health insurance isn’t simply something that is nice to have. It is a major necessity. For this reason alone, discovering a policy that will keep you healthy without placing financial strain is very much important. Since this is personal health insurance, you are the ultimate decision maker when it comes to how much you are willing to pay for coverage, what policies you would like your plan to have, as well as what your health insurance needs are.

Chances are if you are shopping around for a personal health insurance plan, you are either self-employed, unemployed, working part time, or do not receive coverage from your current place of work. While many insurers these days will sell individual health insurance plans, if you’re between the ages 50 and 65, obtaining an individual plan can be somewhat of a challenge.

You can be faced with this challenge because you may potentially have to undergo a medical exam to prove that you are insurable and healthy. An individual insurance policy may end up being much more expensive than a group policy. Fewer benefits may be provided under an individual policy, and many companies may be much more hesitant to sell you an individual policy if you have some type of medical condition.

When first starting out, you need to check out the options that are available where you live. Once you find this out, you can shop around and determine the plan that best fit your needs.

Questions to Ask Yourself

·         Would a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO) work better for your situation?
·         Do you wish to have both vision and dental coverage?
·         In terms of hospital and doctor bills, how much can the plan cover?
·         How much will the premiums cost each month under the plan?
·         Are things like vaccines and preventative health care covered?
·         Under the plan, what is the maximum life payout?
·         Are prescription drugs covered under the plan? If so, are all types of medication covered or just generics?

Personal Insurance Options

Fee-for-Service Insurance: Also known as Indemnity Insurance, this type of policy is very traditional in the sense that a part of your received medical services will be paid for while you pay the additional costs. Services may include things like hospital stays or doctor visits.

Association-Based Health Insurance: For many people, they are able to obtain their health insurance through a certain association that they belong to. Believe it or not, many community, professional, and religious organizations offer health insurance coverage at group rates for their members. If you are a member under a certain professional organization or trade, be sure to ask if they have a policy available.

Managed Care Plan:  Many these days choose to receive their insurance coverage under a managed health care plan - preferably, Preferred Provider Organization (PPO), or Health Maintenance Organization (HMO), within these plans, certain hospitals and doctors will contract with a health insurance company and health care is provided to the insurer’s members. Under this plan, members will only be able to visit doctors and hospitals that fall under the plan’s “network.” Some plans will allow their members to venture outside of the network, but the cost is typically higher. Under a managed care plan, the plan prepays for your visits and you will pay a co-payment each time you visit. 

Insurance for a Pre-Existing Condition: Because of the health care law recently put in place under the Obama Administration, pre-existing condition insurance plans (PCIPs) have been put into practice in each state by the federal government. To get health insurance under this plan, you must have a pre-existing condition, be a U.S. citizen, have been denied previously because of your condition, and not be insured for at least six months.


This article was written by Karl Stockton for the team at

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