Individual Health Insurance Overpriced - Insurance Consultant Needed

Florida Health Insurance Consultants are recommended for anyone buying health insurance. Recent polls taken by the Wall Street Journal said, "18 percent of American's do not have health insurance coverage" of any kind. 40% of those polled did not know the difference between a PPO and an HMO.

Finding affordable health insurance has never been easy; it is not 'one size fits all.' Now, with the increases in policy rates, hardly anyone in Florida can 'afford' to stay healthy. Depending on your current state of health, budget and individual needs, the best insurance for you may be far different than the best insurance for a friend or another family member. What can you do protect your family? Contact an expert insurance consultant and talk to them about your needs. They can show all available policies, not just one policy from one carrier.

Florida's new governor may help the situation. Residents say 'without new laws to protect them against insurance companies there is no help in sight.' Don Winters, longtime resident of Palm Beach said in an interview with F.N.N., 'Either we get affordable health insurance, or we'll find a Governor 'like Arnold' who will get it for us ... there is no other option.' Governor Crist's office says health insurance in one of the Governors top priorities.

One thing you can do to find the best policy now for your health or home is to have a basic understanding of the various types of insurance that are available in Florida, and what each does and does not cover. That can be helpful in determining which plan will work best for you. Before you buy insurance for any purpose, a talk with a 'Florida health insurance consultant' can save literally thousands of dollars per year.

There are two basic types of managed care -- HMO and PPO. With a Florida HMO, or Health Maintenance Organization, you pay a monthly premium in exchange for comprehensive medical care. There is usually a small co-payment for doctor's visits (usually ranging from $5 to $25), and a somewhat higher co-pay or deductible is needed for hospitalization. The upside to this HMO Plan is: Your out of pocket expenses are significantly easier to predict and manage with an HMO rather than a fee for service plan. However, the downside of this plan is: an HMO introduces the concept of a 'gatekeeper.' In an HMO, you must choose a primary care physician. That doctor, working in tandem with a risk management insurance officer, will determine your access to specialists. Finally, a Florida HMO plan requires you to use doctors that are part of the Florida HMO's network. If you travel a lot, be sure to find out what the provisions are should you require an out of network doctor.

The other type of plan is the PPO. A PPO, or (Preferred Provider Organization), can be considered a blend of HMO and fee for service plans. You will choose a primary care physician in Florida, and generally use doctors that are part of the organization. However, a PPO lets you see doctors who are not part of the network for a somewhat higher fee. This increased flexibility is excellent for those who travel frequently, or for those whose current doctor is not a member of the organization.

Get more information from a Florida health insurance consultant

Further details about HMO/PPO Plans/Fee for Service Policies

Do you know what category your group health insurance plan falls under? There are three major types of group health insurance plans in the market place. Make sure you have the facts and choose a plan that meets your philosophical ideals:

The first plan is called an HMO (Health Maintenance Organization). HMO’s are highly focused on managing your health care and telling you what Dr.’s and hospitals you can choose. They believe that preventive care should be used to keep individuals on the plan healthy. Many HMO polices cover your preventive bookwork, mammograms, and all items associated with annual physicals. They try to keep these types of plans cost effective by offering a much smaller network than some traditional plans. They tend to negotiate very good contracts with the medical industry, thus they can keep their costs low.

In many cases over the past few years HMO’s have caught a bad wrap. With new technological advances in healthcare many of the new types of treatment are not covered under HMO certificates. If you want choices when it comes to making serious decisions regarding your health in a time in need an HMO is probably not the plan for you. HMO health claims are paid on reasonable and customary charges.

The second type of plan is called a PPO (Preferred Provider Organization). Insurance plans that are PPO certificates allow participants some choice in their personal providers. Most PPO’s offer you benefits that will be covered as in or out of your network. Although you will get the greatest benefits going to providers in your network, it is nice to have that option of a higher copay or deductible, out of your network. PPO health plans are the most popular. Having the option to go in network and out of network makes PPO’s very attractive. PPO health claims are paid on usual and customary charges.

The third plan is called a fee-for service plan. Fee for service plans are the best in the industry. The carrier pays the provider directly for the balance of fees due after the participant pays his/her required portion. Individuals can choose whatever Dr. or hospital they would like to use. In many instances you will have to pay out of pocket fees up to the limit of a set deductible before the insurance carrier pays for everything else. These are a more traditional way of thinking about health insurance. Fee for service health claims are paid on regular charges.

Has this helped you figure out what type of group health plan fits for you and your employees? Within these three types of plans the benefits with each certificate will very a great deal. In addition to figuring out what plan type you need to services your needs. You must also make sure you find out how responsive the carrier's customer service department is, how they rate with AM Best in ability to pay claims, and lastly check their complain ratio with the NAIC. This is a very good start to narrowing down what group health plan fits for you. Make sure to consult your broker, web portal, or risk manager before signing on the dotted line.