Ways & How

How to Find Good Individual Health Insurance

How to Find Good Individual Health Insurance

Whether it’s your first time purchasing health insurance or you’re simply thinking of switching to a better health plan, choosing the best individual policy need not be difficult. You simply have to take into consideration a variety of factors and set a limit on how much you can shell out each month for the plan ideal for you. Moreover, though the premium price is an important consideration, it’s not the only factor you should think about. This guide shows you how to find good individual health insurance that perfectly fits your income and lifestyle.

  1. Know what you need. Depending on your lifestyle and status, you can foresee certain medical needs that you may want your insurance to cover. For example, if you’re at the stage of starting a new family, you have to ensure that maternity coverage is part of your chosen plan. If certain conditions run in your family, like heart disease or diabetes, make sure that your health care policy covers the costs of diagnostic procedures and medications. This guarantees that you get the most out of your health care plan.

  2. Check if the network includes your preferred health care providers. If you prefer certain physicians and specialists, verify whether they are part of the network of doctors covered by your health care plan. Your policy will not be put to good use if most of the physicians you want to see are not part of the network of approved providers. To see them, you would have to spend a lot on out-of-pocket costs. The same is true about hospitals, clinics and pharmacies that you go to. Check if they are part of the provider network so you don’t have to spend extra on them.

  3. See to it that your medications are covered. Health care plans list certain drugs as part of the formulary that their policy covers. Make sure that the medications you frequently take are on this list. Medication costs can add up over the long term, especially if you frequently get sick or regularly take certain drugs.

  4. Get to know the different types of health plans. There are three main types of plans: HMO, PPO and EPO plans.

    a. HMO, or health maintenance organization, means that you will be choosing one primary care physician. Whenever you need a medical check-up, you go to that doctor. He or she examines you, and in cases where you need more specialized care, that doctor can refer you to a specialist within the network. This means that all health services you avail of will go through that single physician, except in cases of emergency and for routine medical examinations for pregnant women.

    b. Another kind of health insurance policy is called PPO, or preferred provider organization. This plan allows you the flexibility to go to any physician, whether general practitioner or specialist, within your network even without a referral. PPO plans usually have a wider network of physicians and suits those who see a lot of specialists. If you opt to go outside your network, however, not all services and fees will be covered.

    c. EPO, or exclusive provider organization, is another type of health care plan. It essentially combines the features of HMO plans with PPO plans in that you chiefly have access to one general physician and a number of specialists. This type usually provides a more limited network of doctors, but it offers you savings compared to a PPO plan. This is much more ideal for people who do not have the need to frequently see many specialists but still want access to a variety of physicians.Any of these three plans may work for you depending on certain factors like your age and pre-existing conditions, although HMOs are more affordable than the other two. Choose which plan best suits your medical needs to make the most out of your premiums.

  5. Compare and evaluate different plans. Review the main benefits of each plan, consider the costs and make sure that you check for such things as cost-sharing, co-pay and coinsurance and even the annual limit. These figures help you make the final decision, since some plans at first may seem ideal but may have certain features that can burden you with costly out-of-pocket payments and cost-sharing aspects that you didn’t know about. Various websites like nahu.org, HealthCare.gov and eHealthInsurance.com can give you a comparison of various plans.

All in all, knowing how to find good individual health insurance will help you wisely decide which health policy gives you the most out of your payments. Finding the best health plan will give you the peace of mind that comes with knowing you don’t have to panic every time a medical emergency happens.


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