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Health Insurance Guide
A Few Things To Think About When Selecting Individual Health Insurance Coverage
With so many choices available it's difficult to know just what to look for when selecting health insurance coverage.
The first thing you need to establish is just what your particular needs are. For example, do you need cover for just yourself or are you looking for a plan to cover yourself and your spouse, yourself and one child, or your whole family? This is a fairly easy question to answer, but the next one is a bit trickier.
What exactly do you need in terms of your health? Are you and everyone else who will be included in the plan in good health or do you have any pre-existing conditions which will need to be taken into account? Does anybody have special medical needs or are they going to need treatment by certain medical specialists or in particular medical institutions?
Next, if you are arranging cover through a group scheme provided by your employer, you need to know the options that are open to you. Your choices will be limited to those provided under the plan that the company is offering and this might or might not make your decision easier. If you are not considering cover under an employers group plan then, before you go any further, you will need to have an understanding of the differences between an indemnity plan and a managed care plan, or one of its variants.
Indemnity health insurance plans allow you the freedom to choose where and when you seek medical treatment. This freedom comes at a price and will usually be accompanied by high out-of-pocket costs but, in many cases, this can be a reasonable trade-off.
Managed care plans are more restrictive and you will have to seek treatment from doctors and facilities within the managed care plans network. For treatment beyond that which is normally considered as basic care you will also normally have to seek pre-approval. Costs under managed care plans are lower than those under indemnity plans and if you are not worried about where and by whom you are treated, or need to keep a close eye on your medical costs, then managed care plans might be a good option for you.
Naturally, this is a very basic comparison and you will need to investigate further depending upon your own personal circumstances.
Having decided what type of plan you need, the next problem is how to choose the right insurance company. There are numerous companies providing health insurance today ranging from small independent organizations to the well-known corporate giants. Here it is very much a matter of personal choice and you will need to do your research. A good place to start might be to ask friends and colleagues or indeed your own family doctor. The Internet can also give you a wealth of information on the whole range of health insurance providers and is an excellent place to discover health care insurance company rankings and to find an online major medical insurance company.
Get a free individual major medical insurance quote today.
Closed formulary: The provision that only those drugs on a preferred list will be covered by a PBM or MCO.
Federal Employee Health Benefits Program (FEHBP): A voluntary health insurance program administered by the Office of Personnel Management (OPM) for federal employees, retirees, and their dependents and survivors.
National Practitioner Data Bank (NPDB): A database maintained by the federal government that contains information on physicians and other medical practitioners against whom medical malpractice claims have been settled or other disciplinary actions have been taken.
Termination without cause: A contract provision that allows either the MCO or the provider to terminate the contract without providing a reason or offering an appeals process.
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