How do you choose the best health insurance policy? The answer really depends on your situation in life. Someone who is young and single is going to have far different needs than someone who is older and has a family depending on the health insurance. If you are shopping for health insurance plans, here are some of the considerations you need to make.
HMO, PPO, or POS
One of the first choices you may need to make is which structure your health insurance policy will have. The three most common are HMOs, PPOs, and POSs. An HMO, or health maintenance organization, is probably the most affordable option. However, you will have many limitations with an HMO as to which doctors you can visit, and there is often a lot of paperwork you must go through in order to obtain certain medical procedures or get a visit with a specialist. In an HMO, your doctor is paid a set fee each month for each patient under his care, regardless of whether or not a particular patient receives care that month. You are required to visit doctors who are in the HMO.
With a point-of-service, or POS, your insurance provider only pays when you receive services. You have fewer limitations as to the doctors you can see, but you may be required to pay a portion of the cost each time you receive care. You will have slightly more flexibility if you need specialist care under a POS plan.
A PPO, or preferred-provider-organization, is like a combination of the two previous policies. Like an HMO, you are going to be better off if you choose a physician that is part of your network. With a PPO, your insurance will pay more for your care if the provider is in the network. However, unlike an HMO, you can choose to go to a doctor who is out of the network, you will just have to pay more out of pocket to do so. You will also have a deductible and co-pays with this type of insurance.
Deductible Vs. Premium
The deductible, or the amount you must pay out of pocket before your insurance will kick in, directly affects the amount you pay for your premium. The higher your deductible, the lower your premium will be. However, finding the right balance between the two is not always easy.
If you are going to be using your insurance regularly, such as if someone in your home has a pre-existing medical condition or if you have children who need regular checkups, you may want to pay a little more for your insurance premium in order to have a lower deductible. However, if your insurance is to be used for potential major health problems that you might face someday, but right now you are relatively healthy, a higher deductible in return for a lower premium may be more beneficial.
Look at Prescription Drug Coverage
Not all insurance policies have prescription drug coverage. The best health insurance policies will cover your prescriptions. If the policy does not cover prescriptions, find out if it offers a discount plan you can use towards drug expenses.
Look at Lifetime Maximum Benefits
Many insurance products will put a cap on the amount you can receive in benefits. This is called a maximum lifetime benefit. These will apply to individual treatments, such as cancer, mental illness, or organ transplants. If the insurance has very low caps, such as $100,000, you need to find something else. Medical expenses add up quickly, and you do not want to be paying for coverage that is not going to be sufficient if you have a severe medical problem in the future.
Choosing health insurance is never easy. Be sure that you work with a qualified agent who can answer all of your questions. Pose various scenarios to see how the insurance would cover situations that could occur in your future. This will help you choose the best health insurance for your family’s needs.
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Filed under Health Insurance by on May 6th, 2009. Comment. 
In these days of rising medical costs it is only natural that you should shop around to find the best deal when it comes to an individual health insurance plan and, for most people, that means looking for a good insurance company offering cover at an affordable premium. Unfortunately, it is not quite that simple.
Before you start to worry about how much you are going to have to pay for health insurance you must first determine the type of health insurance that you need, as there are several different forms of individual health insurance plan available today.
There are essentially three main types of health insurance.
The first is tradition indemnity (fee-for-service) insurance. This is a form of insurance that many people will be familiar with and which, a few years ago, was the dominant form of health insurance. Today, however, it is generally considered to be an expensive option.
Indemnity health insurance is not designed to cover day-to-day medical care but instead provides cover for unexpected illnesses and, more often than not, allows the policyholder considerable freedom when it comes to choosing where to go and who to see for treatment. The policyholder is also responsible for much of the administration of an indemnity policy and is required pay his own medical bills in the first instant and then to complete the necessary claims forms to gain reimbursement.
Because indemnity insurance is designed to meet unexpected medical expenditure policies will seldom cover routine medical bills.
The second form of health insurance is referred to as managed care and the best known example of this is the original Health Maintenance Organization, or HMO.
The principal behind HMOs is to reduce overall medical costs by focusing attention on keeping the policyholder in good health and catching potential problems at an early stage when they can be treated easily and relatively cheaply. Accordingly, HMOs focus on providing cover for routine medical care and for such things as screening and check-ups.
There are two other significant differences between indemnity insurance and managed care. The first is that managed care operates within a managed care organization and the insurance company handles all of the paperwork and the payment of bills. The second is that, because treatment must be carried out within the managed care group, the policyholder has far less choice over where and from whom he receives treatment.
HMOs were not generally well received when they were first introduced and came in for a great deal of criticism, much of which was justified. HMOs have done much in recent years to meet this criticism and have been largely successful in doing so. However, this process has also given rise to the third form of health insurance today, and one which is gaining rapidly in popularity, Preferred Provider Organizations, or PPOs.
PPOs are essentially a mix between indemnity and managed care with care being provided normally under the umbrella of a managed care organization but with policyholders having the freedom to seek treatment outside of the organization in certain circumstances.
Which form of insurance will best suit your needs if course dependent very much on your personal circumstances. If you are young, fit and healthy and visit the doctor once in a blue moon then you may feel that indemnity insurance would best suit your needs. If, on the other hand, you are married with four young children and have a history of health problems within the family then the focus on preventative medicine provided by managed care may be more attractive to you.
The important point to remember here is that your starting point in looking for an individual health insurance plan should be to decide upon the type of plan that you need and only then should you move on to look at how much it is going to cost.
For more information on finding a suitable individual health insurance plan and low cost health insurance there is no better place to start your research than right here on the Internet.
Filed under Health Insurance by on Apr 28th, 2009. Comment.