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Choosing the Best Health Insurance Plan

• Individual Health Insurance – A type of health insurance policy that you can buy yourself. There are several sub-groups under this heading such as HMO and PPO.
• Family Health Insurance – This is the same type as individual health insurance except that it covers several people in a family. There’s only one primary policyholder but each family member is covered under the main policyholder.
• Indemnity Plan – This plan provides for a greater freedom to choose health care providers because they do not need to belong to a particular network. You can choose any physician but it requires a deductible and there may be instances where you’ll need to pay for your visit. In these cases, you issue a reimbursement claim from the insurance company. The policy rate to be paid on your claim is determined by the health insurance company, based on industry standards (usual, customary, and reasonable), that is set before you purchase your policy.
• Co-Payment – This is a charge that’s agreed upon by you and the insurance company before you buy your plan. Based on your policy terms, visits to physicians or prescriptions may require co-payments. The amount is usually about $20 per visit, but range around $15 to $50 per visit.
• Deductible – This is a fixed amount set by the health insurance company. The company will only assume responsibility for qualified healthcare and medical expenses beyond this deductible amount. Once you pay your deductible, your insurance policy will cover any additional costs for that year. In a family health plan, each member has their own deductible.
• Co-Insurance – This is an amount, ranging from 10% to 80% of the total cost of a procedure that you may be required to shoulder, based on the terms of your policy. It’s distinct and separate from co-payment and deductible. For instance, if a procedure costs $1,000 and your co-insurance is 20%, you will pay $200 and the health insurance company will cover the rest.
• In-Network Provider – This is any physician or healthcare professional that has a contract with your health insurance company. You can avail of maximum coverage when you use the services of an in-network provider. A list of these providers is included in your policy.
• Out-of-Network Provider – This are healthcare professionals that do not have a contract with your insurance company. You may receive partial coverage or no coverage at all, depending on the type of your plan.