What To Know If You Are Buying Your Own Health Care

Most everyone would agree that health insurance is especially extra nice if someone else is paying the bill. This however is reserved for employees who are considered full time employees. Part time workers, self employed and students are a whole different segment of the work force and must seek health care coverage options on their own. This can have looming implications if an illness or injury is unplanned without the security of health insurance and could easily result in bankruptcy. Just knowing how to select the best policy to serve the needs of the individual can be a daunting task.

Considerations of individual health insurance plans. The biggest concern that most people have when purchasing their own health insurance policy is the cost, since they can be quite expensive. Perhaps more important than the cost, however, is for the purchaser of health insurance to understand what he or she is getting in exchange for a monthly premium. Policies with an identical price could provide vastly different coverage options, so it is important to research each plan thoroughly before making a decision.

The HMO plan is probably the most common type of policy offered in the health care coverage industry. HMO is an acronym for Health Maintenance Organization and made up of a vast network of health care professionals and facilities such as doctors, hospitals, pharmacists and a host of other health care providers that have an agreement to provide services to the insured patient. This process is started by the policy holder choosing from a list of providers and facilities one of each to be their primary providers. Patients will have to always see their primary care physician first before they are allowed to see or be referred to any other specialized treatment. It is reported that some HMOs must have a referral from the primary physician before they will pay for the services rendered.

HMOs are not the only choice for people seeking to secure coverage for themselves. There is another very credible coverage plan known as a PPO (Preferred Provider Organization) but it is also known as a self-directed plan for people that don't want to participate in a HMO plan for whatever reason.

Deductibles and Co-Insurance. Most self-insured plans require payment of a deductible before any benefits are paid on the plan. The lower the deductible, the higher the monthly premium payment will be. Deductibles can range anywhere from $500 to $10,000 or more. People who opt for high-deductible insurance plans may also choose to open a health savings account (HSA) to set aside money on a pre-tax basis for qualified medical expenses. Co-insurance refers to the amount the plan pays verses the amount the participant pays. An 80/20 split is common.