Need Help Selecting the Right Medical Insurance Plan?
Let us help you simply the process of shopping for an individual, family or self employed medical insurance plan. Use the Key Features of Medical Insurance At-A-Glance Chart to help you determine the type of individual medical insurance plan that is best for you and your family.
|Key Features at a Glance:||Traditional HMO||Traditional PPO Plan / POS Plan||High Deductible Medical Insurance Plan||Short-Term Medical Insurance Plan||Guaranteed Health Insurance / Limited Benefit / Mini Med|
|Comprehensive (Major Medical) coverage||
|No, considered supplemental medical insurance|
|Lifetime Policy Limits (per person)||Unlimited||Unlimited||Unlimited||$1 million to $2 million||Not applicable – fix payment applies to each covered expense|
|How benefits are paid||Members generally pay copayments for healthcare services, supplies and prescriptions||Insureds typically pay copayments for some healthcare services, such as office visits, x-rays and prescriptions. All other covered expenses are subject to deductible and coinsurance. Once the insured meets the out-of-pocket maximum, the policy pays 100% of all remaining covered expenses for the duration of the calendar year, up to the per person policy coverage limit.||All covered expenses are subject to deductible and coinsurance. Once the insured meets the out-of-pocket maximum, the policy pays 100% of all remaining covered expenses.||All covered expenses, including prescriptions are subject to deductible and coinsurance. Once the insured meets the out-of-pocket maximum, the policy pays 100% of all remaining covered expenses.||The policy pays up to a stated or predetermined dollar amount for each covered expense. For example, the insured may receive up to $50 per office visit and $500 for each day of hospital confinement.|
|Policy is renewable||Coverage for 1 year or less, then policy expires|
|In/ Out of Network Coverage||Limited benefits payable for non-network services||Use any healthcare provider||Use any healthcare provider|
|Guaranteed Acceptance / Medical Underwriting||Usually no medical underwriting or health requirements to qualify||Subject to full medical underwriting. Adult applicants with pre existing medical conditions may not qualify||Same as Traditional PPO Plan (subject to full medical underwriting)||Abbreviated medical underwriting to qualify. Accept or reject decision by medical insurance company|
|How premiums are calculated||Individuals generally pay the same for each covered family member||Age, gender & health status||Age, gender & health status||Age and gender||Individuals generally pay the same for each covered family member|
|Waiting period applies for pre existing health conditions||No|
|Premium rate up and/or Exclusionary Rider for existing health conditions||No||No||No|
|Premiums – Cost|
|Maximum out-of-pocket exposure|
|Which statement describes your medical insurance situation?||Traditional HMO||Traditional PPO / POS Plan||High Deductible Medical Plan||Short-Term Medical||Limited Benefit / Mini Med|