How To Choose The Right Insurance Pt. 3

With health care premiums growing, it is becoming more and more difficult for companies to offer health care benefits to their employees. For those employees who are not receiving health care benefits, or for those individuals that are self-employed, there are still many options available to you as far as health care insurance.

Although the health care premiums and out of pocket expenses tend to be higher, it is still possible and important to find a health care plan that will cater to your needs. When you are shopping for your own insurance, especially if you are self-employed, it is important to remember the following details.

The first being that in this case the premium cost is not being split with the employer and so the self-employed individual is responsible for paying the entire premium. In addition, in most cases a self-employed individual is able to deduct the amount of money they are spending on their health care premium from their federal taxable income.Some states also offer similar health care benefits.

Since self-employed individuals are shopping for their own plan and are not tied down to the options given by the employer, there are several health care options that are available to them. One can choose between what are known as Indemnity plans and Managed Care plans.

An indemnity plan is not based on “network based coverage” and provides a self-employed person lot of freedom in choosing doctors and hospitals, and an individual can change their decision about physicians and hospitals at any point in time. However, with this type of health care plan the individual will have to pay for part of the medical bills because the insurance will not cover them.

In addition the amount they pay for health care services may be higher than those self-employed individuals that have a managed care plans. In addition there is a certain amount that a self-employed individual must spend annually. It is only after that point that they will get benefits.

In a managed health care care plan there is a lot less flexibility, but a larger amount of services are covered. In addition, because it is a network of physicians and services, the premiums tend to be much lower. There are still expenses, however, instead of paying out of pocket for services, there will simply be a co-pay for most routine medical visits. This can range anywhere from $5 - $25 per visit.

There is also a list of phamaceutical drugs that will be covered by the insurance company. It is important to know what drugs are covered by the health care list when choosing a plan, especially if the self employed individual or anyone in their family has medication that they are taking on a regular basis.The cost will depend on whether or not one is receiving the generic version, or the brand name, and whether or not it is covered by the list which is called a “formulary”.

It is possible to find a "self-employed" plan within either system that will cater to your needs. It is only a matter of what you want to spend. The most important thing is that the correct plan is chosen so that you can preserve your well-being. For in the end, the goal is always to maintain and improve health, and no price can be put on that.

* Information recieved from: U.S. department of Health and Human Services http://www.ahrq.gov/consumer/insuranceqa/insuranceqa2.htm

11/12/2009 10:00:00 PM
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