Individual health insurance plans are quite affordable and readily available from the top health insurance companies. Anthem Blue Cross, Aetna, Medical Mutual, United HealthCare and most other major carriers offer a wide range of policies. Although there are hundreds of available options, there are three principal types of coverage…Catastrophic plans, Comprehensive plans and Health Savings Accounts (HSAs).
Catastrophic Health Insurance
The least expensive policy, this type of coverage will often cost less than half of what a comprehensive policy costs. Major items are usually covered, such as emergency room charges, in-patient and out-patient surgeries and most hospital expenses. Additional expenses such as surgeon fees, facility fees, chemotherapy, CAT Scans and MRIs are also usually covered.
Generally, you choose a deductible (often between $1,000 and $5,000) and the catastrophic coverage begins once the deductible has been satisfied. It is customary for the insured to be responsible for 10%-20% of the medical expenses after the deductible until a cap is met. From that point, 100% of covered medical expenses are paid by the insurer.
Doctor visits, prescriptions, preventative benefits and prenatal care are usually not covered under a catastrophic policy. There also may be limitations regarding certain pre-existing conditions. But because of the substantial cost savings, this type of policy may be an attractive and affordable option.
Comprehensive Health Insurance
Comprehensive plans are the most expensive type of coverage, and also the most popular plan in the US. Most employer-based plans offer comprehensive coverage and the majority of major health insurers offer this type of coverage also.
A typical comprehensive plan uses a Preferred Provider Organization (PPO). With a PPO, the insured pays small copay for covered office visits. Normally, the copays range from $10-$40 and there is no limit on the number of symptomatic visits per year. To take advantage of the low copays, the treating physician must be a member of the “Network.” Here in Ohio, most insurers have large networks, so finding a participating physician is relatively easy.
However, you may use a non-Network physician, although your out-of-pocket cost will be significantly higher.
Comprehensive plans also tend to include pharmacy benefits that cover both generic and non-generic prescriptions. Copays are usually $15 or less for generic and approximately $20-$60 for the more expensive non-generics. Many health insurance plans will have a yearly maximum on the amount of prescription coverage that is provided. Although that amount will be approximately $2,000 to $5,000, it is advisable to consider a rider that provides unlimited prescription coverage.
Health Savings Accounts
Health Savings Accounts (HSAs) were created by the Medicare Bill in 1993 and were implemented to assist individuals and families save for current and future qualified medical expenses on a tax-free basis. To take advantage of an HSA, you must have a High Deductible Health Plan (HDHP). An HDHP is a catastrophic health insurance plan that costs much less than a conventional policy. Normally, you are responsible for the first few thousand dollars of medical expenses before coverage begins. Ohio plans are among the least expensive in the Midwest.
Interest is often paid in an HSA and any unused funds at the end of the year can be used for later years .Since the HSA is portable, you can retain the policy regardless of where you are employed or which insurance company handles your HDHP. Also, many other qualified items, such as dental and vision expenses may be paid from funds in your HSA.
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