Finding the right individual health insurance plan is a challenging task. The following information can help you move through the process much more easily, and you will be better prepared to pick an individual or family health insurance plan that best fits your needs.
By reviewing the following information you will:
Know which individual or family health plan benefits are most important for your specific needs.
Learn how to compare different health plans to get the most out of individual health insurance quotes.
Understand how to evaluate a plan and its doctors for the quality of care provided.
Discover strategies in using more than one plan to meet the needs of both you and your family.
Get good tips on choosing a doctor.
What individual health insurance benefits are most important to you?
A good place to start in selecting an individual health plan is to take a good look at your personal health situation. If you check your health records and make a list of the health services that you have used over the last two years, you can determine what benefits need to be provided in any plan you choose.
In addition, you may want to consider these questions:
Do you have any heath conditions which require frequent visits to the doctor?
Do you take prescription medications on a regular basis?
Are you seeing a specialist on a regular basis
Is preventative care, such as annual physicals, mammograms, PSA tests, and colonoscopies important to you?
Do you have a current doctor that you trust and want to stay with? What plans does he/she accept?
Do you have young children who need regular attention?
Is a pregnancy being planned?
What kind of health issues have your parents faced?
As you are reviewing your past medical records, it would be very beneficial to summarize what you have paid in medical expenses over the previous two year period, including what you have paid in health insurance premiums. You can use this information when we put together our cost-cutting strategies.
Comparing Individual Health Insurance Plan Benefits
In comparing health insurance plans, it is important to look at what each plan covers. For a printable comparison sheet click here.
Ask whether the following services are covered. What are the dollar or time limits of these covered services? For example, what are the policies regarding length of stay in the hospital when delivering a baby?
Medical Services Checklist: Plan A Plan B Plan C
Inpatient hospital services
Outpatient surgery
Physicians visits (in the hospital)
Office visits
Skilled nursing care
Medical tests and X-rays
Prescription drugs
Mental health care
Drug and alcohol abuse treatment
Home health care visits
Rehabilitation facility care
Physical therapy
Speech therapy
Hospice care
Maternity care
Ongoing care for chronic diseases
Chiropractic and alternative treatments
Preventative care and checkups
Well-baby care
Dental Care
Other covered services
Services specifically excluded
Additional questions:
Are there any medical service limits, exclusions, or pre-existing conditions that will affect you or your family?
What types of approval or pre-authorization are required?
What are the rules for ambulance and emergency room treatment?
Cost Comparison Checklist: Plan A Plan B Plan C
What is the monthly payment
How much is the co-payment for office visits
What is the deductible per person
What is the deductible per family
What is the co-insurance after I meet my deductible
What will I pay if I see a doctor outside the plan
What is the maximum to pay out-of-pocket each year
What is the maximum lifetime benefit
Evaluating Individual Health Insurance Plans for Quality of Care
There are some good online resources to help you investigate an individual or family health insurance plan. First, you can get a health plan report card. This will give you information on the ease of the plan’s access to care and customer service; how well the plan screens its doctors and how members rate them; how strong their services are in helping members stay healthy; how well they do at helping members get better during a health problem; how well they help members with chronic illnesses; and the plan’s accreditation rating.
You can also check your state insurance department to see if there have been serious complaints about the plan, and whether it is in compliance with all state rules.
Should you use more than one individual health insurance plan?
There are some circumstances where it makes sense to use more than one individual health insurance plan to provide the most cost-effective means to meet the family health insurance needs.
If there is a significant age difference between spouses and both need individual coverage, quotes for individual and family health insurance plans should be gathered. If there are children, add them to the younger spouse’s plan to compare prices.
If one spouse smokes or has some health issues, separate individual health insurance plans may be less expensive.
If there is are financial limitations, children can have separate policies.
If you have a college student getting close to graduation or leaving school, there are plans designed for them.
Tips on choosing a doctor
Once you have chosen an individual health insurance plan, the next step is selecting a doctor either as your primary care physician in the case of an HMO or POS plan, or as your regular doctor with a PPO or fee-for-service plan.
Review any background information your health plan may have on its doctors.
Check whether or not they are board certified in a certain field or specialty. This free search can tell you if your doctor is board certified in a specific specialty area.
Ask if the doctor you are considering is taking new patients from your individual health insurance plan. Often, highly regarded doctors are heavily scheduled and must limit the number of new patients they will see.
Ask how far ahead you must schedule an appointment.
Some states publish any disciplinary action or medical malpractice claims.
We now have solid information on the types of plans and a sound approach to selecting the right individual health insurance plan. Let’s get to the ideas for cost-cutting and then we will be well prepared to make sense out of health insurance quotes.