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Common Questions on Individual Health Care Insurance

Why is there such a difference in price between individual and group health insurance?

Your employer purchases group health through a health insurance company that has offered “low bid.” The company that wins the bid may be the same company that offers personal health insurance, but the group insurance works a little differently and is actually quite expensive. You never see this because your employer pays a large portion of the premium as a benefit to you.

Get your free quote here for rates from private health insurance companies.

How do I find the least expensive policy?
You can research our site, talk to different companies, and compare rates. Be aware, however, that getting the lowest price is not necessarily an ideal goal. You should first decide what type of coverage you absolutely must have, what coverage you would like to have, and what you can handle in terms of a deductible. Then look for a policy that fits your needs. If you shop for price first, you may soon discover that you have sacrificed benefits that mean more money out of your pocket than a higher priced policy would have.

Is there a way to get good coverage and save money at the same time?
Yes, you can find affordable health care coverage if you are willing to consider different types of plans. For example, most people prefer the traditional fee for service plan where you go to a doctor of your choice, pay your deductible and copay and rely on the insurance to pay the rest. This is the also the most expensive type of health coverage. As an alternative, you might consider a PPO or HMO, or even a high deductible plan with an accompanying HSA.

What is meant by HMO or PPO
The acronyms stand for “Health Maintenance Organization” and “Preferred Provider Organization.” They function similarly in that both types of plans work with a network of doctors. The primary difference is that with an HMO, you are required to have a primary care physician who must make a referral before you can go to a specialist or other doctor. With the PPO, you can go to any doctor within the network without a referral from another doctor.

What is a Health Savings Account?
A health savings account or HSA is a special type of IRA that allows you to save pretax money and withdraw it from the account—tax-free—to pay deductibles and copay as well as premiums. In order to be eligible to set up an HSA, you must first purchase health insurance with a high deductible—at least $2500. This lowers the premium on the health insurance, but also gives you a way to build tax free savings. You are limited in the amount you can contribute to the account each year, but you can save it from one year to the next or until you need it.

Other than Premium, what do I need to look for in a policy?
You want to make sure you know the following details:

Deductible: the amount you pay before the insurance company begins paying;

Exclusions: illnesses or conditions for which the company will NOT pay;

Co-payments: the amount you must pay after your deductible has been met;

Out of pocket max: the most you have to pay in a single year before you have 100% coverage.


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