Individual and Family Health Insurance

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Are you looking for health insurance for you and/or your family? Heidi Olsen Insurance’s award winning agency can help you understand your options, the benefits of each plan and help you find the plan that is right for your needs and your budget. Give us a call Today!

What is Health Insurance & Why do You Need It?

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Health insurance is a system of insurance in which the individual pays a set premium on a periodic basis in exchange for coverage of a set list of health related costs. In other words, health insurance is when you pay a health care insurer to cover a portion, or all, of certain included health related expenses, in the case that you incur them during the term of the insurance. It is generally considered wise that all people carry health insurance, from birth to death. This is because, though young people in their 20s and 30s may have a lower risk of certain medical expenditures, the risk is still real. Any catastrophic medical situation, a major car accident for example, could leave them both unable to work and unable to pay for their medical treatment if they do not have healthcare insurance. It really doesn’t have to be a catastrophic medical situation to have a catastrophic effect on one’s finances and choice of care. The cost of fixing a broken bone, a minor surgery, or prescription drugs for illnesses and infections can add up quickly when not insured, which, can have lasting financial consequences. Having a health insurance policy assures that you will be able to choose who you get your medical services from, rather than being told where you will get care from and who is volunteering that day.

Is There a Difference Between Individual and Family Health Insurance?

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Individual and family health insurance simply refers to health insurance which is offered to individuals, or to the family unit, depending on the needs and family situation of the applicant.

Individual and family health insurance is generally offered in any one of several different kinds of networks. Here is a brief explanation of these networks.

• A PPO is a preferred provider organization. It is characterized as a network of doctors, nurses, hospitals, and other healthcare providers, which come under the banner of “managed care.” Essentially the PPO is a group of affiliated medical care providers who receive payments from insurance companies in order to provide healthcare services to the customers of the insurance company. The PPO structure even offers discounts or refunds when you use the services of a healthcare provider who is not in the network.
• An EPO is an exclusive provider organization. This system is very similar to the PPO, but differs in that while there may be reimbursement in the PPO when you use an out-of-network provider, in the EPO there is no out of network coverage, except for emergency services.
• A HMO is a health maintenance organization. The HMO set-up generally requires you to select a so-called “primary care physician”. This person would act as a “gatekeeper” for all other medical services, such that if you want to see a specialist or have a procedure done the primary care physician will have to give you a referral. This is different from the PPO and EPO set-ups. Also, the HMO has it’s own network of doctors and does not provide out of network coverage, except for emergency services; similar to the EPO.

How to Purchase Health Insurance

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There are many ways to purchase healthcare insurance. Your employer may offer health care, and allow you to enroll during the open enrollment period. Alternatively, you can purchase insurance directly from an insurance company if you are relatively sure of the coverage you desire. Many people go to an insurance agency or broker, like Heidi Olsen Insurance, in order to be able to compare many different plans and coverage from different companies, in order to choose the best coverage at the best price. Heidi Olsen Insurance can help you find the plan that is right for you and your family whether it is on the Exchange or off the Exchange. Give us a call today!

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