Individual and Family Health Insurance

Many people participate in employer provided group health insurance plans. For those who qualify, especially when the employer is paying part if not all of your premium, this could be your best option. However, for the millions of us where this is not an option, it is still very important to seek coverage. Individuals and families have access to a wide variety of excellent and affordable health plans. In addition to being cost effective, these plans are portable which means your coverage will never be affected by a job change or job loss. It is your health plan for as long as you choose to remain on it.

The objective of any health insurance plan is to limit your exposure and reduce your financial risk should something unforeseen happen. In addition, most plans allow for routine medical expenses such as an annual physical to be covered. There are several components to a plan that you can choose:

Co-Payment: This is the flat fee you pay for specific areas of the policy where the deductible does not apply. For example: $30 physician visit; $50 urgent care; Prescription: $10 Generic, 25 Brand, and $40 Non Brand.

Deductible: This refers to the financial exposure that the insured will be responsible for before the benefit begins. This does not include co-payments and applies primarily to PPO policies.

Co-insurance: Once the deductible has been met, this is the portion that is shared by the insured and the insurance carrier. It is the difference between the deductible and the maximum out of pocket. Most plans are 80/20 or 70/30 with the lower number being the responsibility of the insured. For example, if the medical bill is $2,000 and the deductible is $1,000, if you have an 80/20 plan then you would owe $1,200 (the $1,000 deductible plus 20% of the rest which would be $200). Once you have met your deductible and reached your maximum out of pocket, the insurance company will pay 100%.

One of the keys to a good health insurance plan is that you never pay more than the contracted rate. This fee has been pre-negotiated by the insurance carrier and represents the amount of money the carrier will pay the physician, hospital, pharmacy, or clinic. You should never pay more than the contracted rate….I guarantee it!

My goal is to educate my clients so that they limit their exposure and receive the benefits they want and need. Together we will choose an affordable plan without compromising quality. I want to earn your business and serve as your broker.

For additional information or to speak with an insurance expert, please call 301-980-2915 or email info@mrinsuranceofmaryland.com . Here’s to good health!