INDIVIDUALS
& FAMILIES
Individual and Family Health Insurance is made available to you alone, or you and your family, rather than to employer groups or organizations.
Most people would prefer to have their employer provide group health insurance coverage. But, if this is not an option for you, it is still important for you to seek coverage. You may be pleasantly surprised with the variety and affordability of the individual and family health insurance options available.
Types of Health Insurance Plans
To make the correct choice of health insurance, it is important to know about the different types of health insurance coverage options to find the plan that’s best for you and your family.
The most common types of health insurance:
HMO (Health Maintenance Organization)
HMOs give you a primary care physician who has to issue a referral for specialist visits. You get less choice on the doctors you can see. HMO plans offer affordable, comprehensive health coverage with relatively low out-of-pocket costs, but most care must be done in-network to avoid additional costs.
POS (Point of Service)
This plan combines some of the features offered by HMO and PPO plans. As with an HMO, members of a POS plan may be required to choose a primary care physician (PCP) from the plan's network of providers. Services rendered by your PCP may or may not be subject to a deductible. Also, like HMOs, POS plans typically offer coverage for preventive care visits.
Services rendered by a non-network provider may be subject to a deductible and will likely be covered at a lower level. If services are rendered outside of the network, you'll likely have to pay up-front and submit a claim to the insurance company yourself.
HDHPs (High Deductible Health Plans)
An HDHP is an insurance plan which has a high amount you must pay out-of-pocket before it kicks in. Monthly insurance premiums, however, are lower than with other plans.
PPO (Preferred Provider Organization)
These are insurance plans which give you access to a network of doctors under a common agreement. Under this plan, providers agree to charge you less than non-members. In addition, PPOs are notable for giving you wide access to doctors as well as specialist visits without needing a referral.
HSAs and HSA-Compatible Health Insurance Plans
HSAs and HSA-compatible health insurance plans are becoming more and more popular. Here are the basics:
An HSA is a tax-favored savings account that may be used in conjunction with an HSA-compatible high deductible health insurance plan to pay for qualifying medical expenses.
Choosing an HSA-compatible health insurance plan may help you save money. Typically, the monthly premium on an HSA-compatible high deductible plan is less expensive than the monthly premium for a lower-deductible health insurance plan.
Contributions to an HSA may be made pre-tax, up to certain annual limits.
Funds in the HSA may be invested at your discretion. Unused funds remain in the account and accrue interest year-to-year, tax-free.
Not all high-deductible plans are eligible for use in conjunction with an HSA.
