Helpful Hints When Shopping for Individual Health Insurance Plans


Make sure when deciding on an individual health policy that you shop around and get several options to consider. Policies can range in what they cover and cost dramatically, so make sure you get the best plan that fits your needs for the best price. Don’t get pulled into all the extras that you don’t need because the additional costs add up. Make sure to contact several groups and are able to sit with an agent and compare all of them or preview the details online. Most importantly, the policy should protect you from large medical costs like hospitalization and emergency treatment. Understand the policy thoroughly and make sure it is what you need. You don’t want to find out later that it didn’t cover something you needed. Make sure you check to see when the policy starts paying and what is covered and excluded. Always check to see if there is “free look” clause that allows you some time to review the policy at home and make sure it fits your needs. That way, if you decide it isn’t what you want you can return it and get refunded your premium. Make sure to look out for single disease policies, these are very disease specific and not needed if you have a regular medical plan. Most major medical plans cover all diseases that are acquired after the purchase of the insurance.

Always remember to read your application, especially if the insurance representative completed the application for you. This allows you to make sure all the information is correct and exactly what is being submitted. The company can decline the policy if information was not disclosed on the application that was required. All health plans have a provision titled “Exclusions and Limitations.” Make sure you read that section over carefully for your policy so you know what to expect. If it doesn’t cover some things you know you might need or want coverage for, then don’t buy this policy and keep searching. If a benefit or service is limited or excluded, you will not be covered even though treatment may be considered medically necessary.

In addition, before an insurance company will accept you as a potential policyholder, the company may want to know if you have any pre-existing illnesses that require constant treatment and care. They might want to place an exclusionary rider on your policy for a specified condition. If the policy is issued with an exclusionary rider you will be responsible for the cost of any medical care received for the treatment of the excluded condition. This can pose a problem if that is why you want the policy, so be sure they will cover any already existing medical needs you might have. Individual policies generally pay benefits for your spouse, and on your dependent children up to the age specified in the policy. However, your insurance company cannot terminate coverage for dependent children who lack other means of support due to mental or physical handicaps.

Some individual policies contain both In-Network And Out-of-Network benefits at different percentages (In Network 90% vs. Out-of-Network 60%). The insurer is not required to pay the Out-of-Network provider at a higher percentage and it will be your job to pay this if you chose to go outside of your network. Use caution when making the decision to utilize an Out-of-Network provider for medical care and Treatment. You may find yourself paying more than you anticipated. Most groups have an array of medical personnel in all branches to choose from or are referred to. It is a good idea to look at the handbook of providers in your area to make sure there are plenty of doctor available in your area. It would also be a good idea to see if they accepting new patients with the insurance you are considering purchasing. Buying a policy would not be a good idea if none of the doctors are taking new clients at the moment and you have to travel completely out your town to find a doctor who can see you. Make sure that you know whether or not your particular plan requires referrals to other care providers from your general practitioner. If you choose to see another doctor with out a referral you can find you will be responsible for entire bill.


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