Purchasing an Individual Medical Insurance Plan

Buying a private healthcare policy can be a stressful experience for those who have always been insured by their company's health plan. I've specialized in helping my clients locate quality health insurance for well over ten years now and have been an insurance broker since 1985. I've outlined the process we use to help our clients find the right plan for their needs.

The 3 areas we focus on are affordability, quality of coverage and the strength of the insurance carrier.

Insurance carrier- Your health insurance company should be stable financially and have a history for paying claims.

Quality of coverage - The medical coverage must meet your needs. It should cover doctors, hospitals, labs and prescriptions. It should also have doctors and hospitals in their networks that are close to your home.

Price- Your medical plan must be priced competitively relative to the benefits provided.

The basic process we use is to:

Determine which private medical companies are worthy of being considered.

Determine which choices offered by those health care companies offer proper coverages

Determine which insurance plans have the lowest overall cost relative to the health insurance benefits provided

Health Insurance Companies

An individual healthcare provider should have good financial ratings and be in good standing with your state's insurance department. You may also want to do a web search for complaints.

You might search for "Mega Health complaints" before buying a policy from that or any other company. All healthcare company has some unhappy customers just by virtue of the volume of clients they have. However, a red flag should go up in your mind if there are too many complaints.

Another thing to be concerned with is how much they pay in benefits as a percentage of the premium they take in. A good company will write checks for about 80% of the money they take in to cover their clients' healthcare procedures.

Level of Protection - What does your health insurance plan cover?

There are 2 aspects of coverage. One is the treatments that are covered. The other is the network's list of physicians that the insurance policy includes.

Covered Medical Procedures

You should read through your insurance plan's outline of coverage or official brochure to see how doctors, hospitals and prescriptions are covered. Your healthcare policy should cover you in both the doctor's office and the hospital and should have a good lifetime maximum benefit. I suggest at least five million in coverage.

Healthcare Insurance Exclusions and Limitations

Most if not all health care coverage policies will have a list of procedures and services that they won't pay for. Most of the items in this section are reasonable and are included in the plans of most carriers also. Policies usually won't cover a nose job for example. There are are often exclusions that you may find in one insurance policy but not in others. Pregnancy coverage is one example of this. Generally plans will not cover the costs of a the birth of a child. The ones that do usually cost more when compared to otherwise similar plans that don't cover maternity. The exclusions and limitations section of your policy or its brochure should be read carefully before you make your decision about purchase.

Health Insurance Provider Lists

Knowing which doctors are in your health insurance company's network is crucial. You might be able to find a list of doctor's who accept a given insurance plan on the Internet or by calling your health care insurance broker.

Cost - Finding the best low cost medical policy

It is easy to compare individual health insurance costs, but its much harder to ensure that you are getting good coverage for your money.

Comparing Health Insurance Plans

After you have ruled out the companies with poor coverage and/or networks, it is time to look at price as a factor.

The Best Health Insurance Coverage for the Money

The best medical insurance coverage, may not be the best plan for you. Often the best policy is overpriced and does not offer coverage that justifies the extra that it costs. Make sure that any plan you purchase is:

Provided by a good healthcare insurance carrier

Will cover your medical needs well

Fits your budget