PPO and Individual Insurance Policies

Individual health insurance policies are available to anyone who is self employed, unemployed or unable to obtain coverage through work or who wants to supplement their group health plan. Preferred Provider Organizations, more commonly referred to as PPOs, offer great choice of flexibility of health insurance benefits and coverage. Most insurers offer PPOs and purchasing a PPO plan is a wise decision to protect your health and finances.

PPO Basics

• PPO plans are among the most popular type of managed health care plans available. This is because of the flexibility of plan design. PPOs allow individuals to choose any doctor or hospital, however, reduced cost will incur if they seek care from provider in the PPO network. Individual policies allow you to choose how much coverage you need and other variables, such as deductible and co-insurance amounts. Many health carriers have a wide range of provider networks and allow you to seek care wherever you need it.

Finding Individual Policies

• Individuals may prefer seeking health insurance policies through a licensed health insurance agent. Agents will guide your through the entire process from seeking PPO plans, comparing plans based on your needs and budget, obtaining premium quotes, submitting an application and delivering the policy. You can also visit websites, such as ehealthinsurance, which allow you to compare multiple PPO plans in your area. Lastly, you can visit the insurance companies websites to view PPO options and apply online.

PPO vs. HMO

• Besides PPOs, many insurers also offer Health Maintenance Organizations to individual health insurance consumers. HMOs are generally less expensive than PPOs and have much lower out-of-pocket costs. HMOs typically do not have deductibles or co-insurance as PPOs do. However, with these lower costs comes less flexibility than PPO plans. HMOs limit participants to only using network providers and the individual must coordinate all care through a primary care provider. If you see a doctor without a referral and go out-of-network, as you can with a PPO, services will not be covered by the HMO.

Comparing PPOs

• Your primary factor in determining which PPO individual insurance policy your purchase is based on premium cost. The premium is the monthly cost of the policy. Premiums vary based on several factors including deductible, co-insurance amount and your health risk. Generally, the higher the deductible -- the amount you pay before the insurer pays, and the higher your co-insurance percentage, the percentage you pay of all services received -- the lower your premium. Other factors in comparing plans should be provider networks and benefit limitation and exclusions.