Individual Health Insurance 

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Indemnity Plans = Pays up to a certain amount as long as the charge is eligible.  For example a doctors visit that costs $100.  The insurance company pays $75.00 and you pay $25.00.  If the bill is $1000, the insurance company still pays $75.00 and you are responsible for the balance.  The plans sometimes have limits on how many visits they will cover.

PROS

• Can choose any doctor, hospital or provider.  Usually very cheap and many times doesnýt have a deductible or waiting period.

CONS

• Pay more out of pocket.  Sometimes claims may take longer to be paid.

** Good for students and those that are healthy, who do not frequent the doctor. **

PPO = These plans are quite common.  You have a deductible and copay that are fixed.  You pick a doctor from a list of doctors that the insurance company prefers you use, since they have agreed to take a reduced fee.

PROS

• Covers the majority of the charges if using a doctor in the network. 

CONS

• Has a deductible.  Usually these plans are costly.  If you go out of the network you will pay additional out of pockets.

HMO = Also, known as Health Maintenance Organization. Typically covers preventative care, hospitalization, drugs and etc.  These plans can have a deductible and copay.

PROS

• Deductibles are smaller, sometimes they are eliminated.  Copays are usually lower than PPOýs.

CONS

• Must choose among a list of doctors provided by the insurance company.  Known as your general doctor.  You are restricted to that doctor unless they refer you to another specialist.  If you do not have this referral the HMO company will not pay.

HSA = Known as a Health Savings Account.  These are usually high deductible plans that are accompanied by a savings account.  Each year you are allowed to put in so much money. (You are not required) The account comes with a Visa/MasterCard.  You will use this money to pay for your medical expenses before the deductible kicks in.  However, if you do not reach your deductible your money carries over to the next year.  At the age of 65 year the balance can be used to supplement Medicare.  In most cases the banks will pay interest on your money in the account.

 PROS

• Many of the plans can be constructed to pay for 100% of the cost after the deductible has been met.  The cost of these plans is relativity cheap.  You have better control of your healthcare costs.

CONS

• Deductible can be too high