Health Insurance
Individual and Family Plans
What's more important than your and your family's health? Health insurance is the most important coverage to have, but it can often be a very confusing choice to make. Families will often go with a group plan because the costs are lower. For those who don’t have the option of employer-provided health insurance, individual and family health insurance may be the right choice. Price is typically the most vexing aspect in choosing a health insurance plan. For example, premiums for similar coverage from different insurers can differ by as much as 50 percent for the same person. To make things even more challenging, rules and regulations for individual health insurance vary from state to state and are changing on a national level day to day.
We're here to help you find the best coverage, without the headache. Before getting started, it's best to determine your budget, your health requirements, your physician, and your personal approach to healthcare. Combining these factors will help us uncover the perfect health insurance policy for you and your family.
It's important to know the difference between the various organized medical networks when you are looking for health insurance:
HMOs
PPOs
POSs
HSAs
HMOs
The lowest cost option of these networks is the HMO (Health Maintenance Organization). HMOs are set up in regional clinics where you will need to go to visit your primary care physician's (PCP) office, so you'll want to make sure the facility is close to your home. HMOs are often a good choice for families who are healthy and only require mostly routine care. Typically they don't require a deductible, and co-payments are minimal.
HMOs typically offer less flexibility in choosing a physician and hospital than other insurance plans. Another drawback is that you will need a referral from your PCP (Primary Care Physician) before you can see a specialist. It's also important to note that there is typically no coverage for services performed by non-network providers or without a proper referral from your PCP.
PPOs
Slightly more expensive than HMOs, PPOs (Preferred Provider Organizations) offer more flexibility in your choice of physicians and hospitals. PPOs normally don't require you to pick a PCP. Instead, you will be able to see doctors and specialists within the network at your discretion. If a family member needs to see a specialist, PPOs provide a large network of doctors to choose from, and they will cover some of the costs at a lower percentage if you need to go outside of the network.
POSs
A POS (Point of Service) offers a combination of the HMO and PPO plans. As with an HMO, POS members are required to choose a PCP from the plan's network of providers, and services provided by your PCP usually don't require a deductible. Also, like HMOs, POS plans often cover 100 percent of preventative care visits.
However, this higher level of coverage is generally for services carried out or referred by your PCP. Services provided by a non-network provider may require a deductible and will likely be covered at a lower percentage. If services are provided outside of the network, you'll likely have to pay up front and submit a claim to the insurance company yourself.
HSAs
HSAs (Health Savings Accounts) became effective in 2004 and offer a tax-free option for paying your family's health costs. They also have the added benefit of being a possible tax-free savings account. An increasingly popular option, an HSA is a tax-favored savings account that may be used in combination with an HSA-eligible high-deductible health insurance plan to pay for qualifying medical expenses.
Choosing an HSA-eligible health insurance plan may help you save money. The monthly premium on an HSA-eligible high-deductible plan is often less expensive than the monthly premium for a lower-deductible health insurance plan. Another benefit is that contributions to an HSA may be made pre-tax, up to certain annual limits. Funds in the HSA may be invested at your discretion. Unused funds remain in the account and accrue interest year to year, tax-free.
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