Suppose you’re looking to purchase Florida Individual health insurance. We’re here to help you to gain knowledge about fundamental concepts that you must consider:
“Keep in mind if you do not have a major medical coverage to protect you from unexpected medical costs, you would be responsible for paying all these medical bills on your own.”
What is individual health insurance?
Insurance for individual health is private insurance that you purchase directly from an insurance provider
If you’re on this list, you might want to consider getting Individual Health Insurance:
* People between jobs* Self-employees Entrepreneurs
* People in Cobra
* Part-time employees
* Employees whose employers do not provide group insurance
* Early retirees
* New employees awaiting their health insurance coverage from their employer to start
It is helpful to look at the health plans you’re contemplating and think about how each option influences the price of the plan. Things to consider:
* Plan Benefits
* Monthly cost
* Co-pays and Deductibles Coinsurance, Max-out-of-pocket
* Plan for convenience: Access to hospitals and doctors in your local area
* Additional benefits: Dental, Vision Supplemental accident, etc
* Pharmacy
* Maternity
* Exclusions and restrictions
Tips for lowering the cost of insurance:
Take into consideration a high-deductible plan: If you choose a program that has a higher annual deductible will reduce the cost of your monthly premium
What kinds of plans are there?
* HMOs (Health Maintenance Organizations). HMOs are among the most cost-effective health plans on the market and provide complete coverage. HMOs establish networks of specialists, doctors, hospitals, pharmacies, and other health care providers. Most HMO networks comprise thousands of health experts, which means you’ll have easy access to medical treatment in the event you need it.
* PPOs (Preferred Provider Organizations). PPO plans are among the most sought-after in the Individual and Family market. The name suggests that when you have a PPO, you’ll have to obtain medical care from hospitals or doctors in the insurance company’s list of preferred providers to get your claim paid at the top level. It’s your responsibility to ensure that the medical professionals you visit are part of the PPO. The services provided outside the network might not be covered or paid at a lower rate.
* Health Savings Account (HSA) Plans. Two components of HSA coverage include a high-deductible insurance plan and the Health Savings Account. The high-deductible program gives catastrophic coverage as well as low monthly costs. The HSA is an account that is tax-free and lets you will save money for medical bills that are routinely incurred.
* Fee for Service (FFS) Plans. This FFS policy is the most common type of health insurance for individuals. Simply, it provides the healthcare you require, and you’re reimbursed for a portion of the expense.
COMMONLY USED HEALTHCARE WORDS:
Here are some basic concepts you should know when looking at the Affordable Health Plan.
Premiums:
The premiums you pay are the payments you must make to keep your insurance in place. In general, the tips are due each month. The amount of dividends is determined by the insurance company on factors like age, gender, and health condition, as well as the zip code you reside.
Copayments (Co-pay):
A flat charge per service which plan members are required to pay for certain services, such as doctor’s visits or prescriptions.
Deductible:
What is the amount you’ll have to pay for each year’s medical expenses before the plan starts paying benefits in exchange for services covered? Most individual health insurance plans let you choose your deductible.
Today’s Deductibles: $500, $1000, $1500, $2000, $2500, $3000, $3500, $5000, $7500, $10000
Coinsurance:
A percent of the contracted rate payable to an in-network provider or an amount of the expense incurred by an outside-network provider which the user is responsible for. Coinsurance is like copayments. However, it’s expressed in percentage, not dollar amount. A coinsurance percentage of 70/30 means you’ll be accountable for 30% of the medical bill.
Examples of Coinsurance: 100/0, 90/10, 80/20, and 70/30.
In-Network Provider:
Any healthcare company (physician, pharmacy, hospital, etc.) that’s part of the company network.
Out-of-Network Provider:
Any health care provider (physician, pharmacy, hospital, etc.) that isn’t part of the company’s network.
Impatient Care:
The care provided to a plan participant in a facility such as a hospital hospice or skilled nursing facility rehabilitation facility.
Outpatient Care:
Any health-related service is provided to a member who isn’t admitted to an establishment.
Out-of-Pocket cost:
Copayments, deductibles, and coinsurance or other fees that plan members pay for prescriptions or health services.
Out-of-Pocket Maximum:
Most members must pay a year’s medical expenses before the plan covers the remainder of the year.
“Making any major purchase can be difficult. But choosing individual health insurance can be particularly difficult because it touches the things that matter most: your family’s health and finances.”
We can help you with this. A licensed agent can help you understand all the specifics of a health insurance policy and assist you in enrollment.
