Individual and Family Health
Insurance
> Why is this the best place to shop?
> Why am I only seeing quotes from a few companies?
> What
is individual and family health insurance?
> What kinds of individual and family insurance plans
are available?
> How does a PPO plan work?
> How does an HMO plan work?
> How does a POS plan work?
> How does an Indemnity plan work?
> How does an HSA work?
> What is a co-payment?
> What is a deductible?
> What is coinsurance?
> What is the difference between in-network and out-of-network
providers?
> What's the best health insurance plan for me?
> When can my coverage start?
> How can I insure just my child?
> Why should I shop with you rather than buying an
insurance plan elsewhere?
> How do you protect my private information?
> When I buy an insurance plan, how do I make payments?
> If I apply for an insurance plan, am I obligated
to buy?
> Do you offer the best prices?
> Can I contact someone if I need help?
> How does health insurance work?
Our
mission is to provide you with information. All health insurance rates
are filed with and regulated by your state's own Department of Insurance.
Whether you buy from your local agent, Plan Rover, or directly from
the health insurance company, you'll pay the same monthly premium for
the same plan. This means that you can make an informed decision when
purchasing your health insurance plan through Plan Rover and feel confident
that you are getting the best prices!
Plus, by applying online
through PlanRover you are saving yourself several days, if not weeks
in application time usually lost by communicating through postal services.
Why
am I only seeing quotes from a few companies?
Just go back to restart your quote and change the effective date to
a later date. Some companies won't show up in your quotes if your effective
date is too soon.
What
exactly is individual and or family health insurance?
Health insurance that is offered to an Individual and or Family that
does not go through an employer is considered Individual or family health
insurance. If insurance is not available through an employer it is very
important to seek other options in obtaining insurance for you and or
your family. With such a wide variety of options and the affordability
of those options to choose from you might just be surprised at how easy
finding coverage for you and you family can be.
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What
kinds of Health insurance plans are available for individual and or
families?
“Indemnity” or “Managed- Care plans” are the
most common terms used to describe individual and family health insurance
plans. The difference between the two plans are; your choice of healthcare
providers, out-of-pockets costs, and how the bills are paid. Usually
Managed-care plans have fewer providers to choose from and Indemnity
plans will only pay there portion for covered services after they receive
the bill (Meaning you may be responsible for the total bill up front
and then receive reimbursement from your health insurance provider.)
Managed-care plans have several options to choose from. These include
HMO, PPO, and POS plans. Healthcare provider networks are usually used
in managed-care plans. How this works is healthcare providers within
a certain network will agree to perform services for Managed care plan
patients at preset rates and will in most cases submit the claim to
the insurance company for you. In total with an indemnity plan you have
more choices of healthcare providers but with a managed care plan you
will have fewer out-of-pockets expenses and less paperwork
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How
does a PPO plan work?
A PPO (Preferred Provider
Organization) plan has a network of preferred doctors and hospitals
that you are encouraged to use. This network of health care providers
is under contract to give the health insurance plan’s members
a discounted rate.
In general you are not required to pick a primary care physician. This
allows you to choose a doctor or specialist within the network as you
need them.
PPO plans usually have an annual deductible that has to be paid before
the company starts covering your medical bills. In addition to the deductible
there is also a co-payment for certain services or a percentage of the
total charges for your medical bills that will be charged.
In addition Services given by an out-of–network physician are
usually covered at a lower percentage than services given by a network
physician.
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How
does an HMO plan work?
HMO (Health Maintenance Organizations)
plans typically enable members to have cheaper out-of-pocket healthcare
expenses but also offer less flexibility in the choice of doctors or
hospital than other health insurance plans. It is important to remember
that there are many variations with HMO’s. With an HMO, you will
be required to choose a primary care physician (PCP). Your PCP will
take care of most of your healthcare needs. Keep in mind that before
you can see a specialist, you will need to obtain a referral from your
PCP.
With an HMO you will likely have coverage for wider range of preventive
healthcare services than you would through another type of plan. You
may not be required to pay a deductible before coverage starts and your
co-payments will more than likely be very small. Typically, with an
HMO plan you will not have to submit any of your own claims to the insurance
company. Please keep in mind that you will also likely have no coverage
whatsoever for services given by non-network providers or for services
given without a proper referral from your PCP.
-----------------------------------
How
does a POS plan work
A POS (Point of Service)
plan is a combination of features offered by HMO and PPO plans. Members
of a POS plan are required to choose a primary care physician (PCP)
from the plan's network of providers just like an HMO. Typically, services
given by your PCP are not subject to a deductible. Just like with an
HMO, POS plans will typically offer coverage for preventive care visits.
With a POS plan you will only receive a higher level of coverage for
services given or referred by your PCP. Any service you receive by a
non-network provider may be subject to a deductible and will likely
be covered at a lower level. Typically, you are required to pay up-front
and submit a claim to the insurance company yourself if services are
received outside of the network,
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How
does an Indemnity plan work?
Indemnity plans offer a large
amount of freedom when choosing which doctor and hospital to use. They
also will likely have higher out-of-pocket costs and more paperwork.
With an indemnity plan you are free to choose any doctors or specialists
you like with no referrals required. Even if you choose to get the most
of your basic care from one doctor, your insurance company will not
require you to choose a primary care physician.
With more freedom generally comes more cost. You might be asked to pay
an annual deductible before the insurance company will begin to pay
on your claims. After your deductible has been met, the insurance company
will usually pay your claims at a set percentage of the "usual,
customary and reasonable (UCR) rate" for the service. The UCR rate
is the amount that healthcare providers in your area normally charge
for any given service.
With an Indemnity plan you might also be required to pay up front for
services and then present a claim to the insurance company for reimbursement.
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How
does an HSA work?
Health Savings Accounts
("HSA's") were established by legislation and took effect
on January 1, 2004. HSA's and HSA-eligible health insurance plans are
becoming increasingly popular. Here is the breakdown:
• An HSA is a savings account that is tax-favored and might be
used along with an HSA-eligible high deductible health insurance plan
to pay for qualifying medical expenses.
• An HSA-eligible health insurance plan could help you save money.
The monthly premium on an HSA-eligible high deductible plan is usually
less expensive than the monthly premium for a lower-deductible health
insurance plan.
• Pre-tax contributions to an HAS can be made, up to certain annual
limits.
• HAS funds can be invested as you like. Any funds not used will
remain in the account and build tax free interest year-to-year.
However not all high-deductible plans are eligible to be used along
with an HAS. Click here for more details on HSA's
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What
is a co-payment?
A "co-payment"
or "co-pay" is a specific charge that your health insurance
plan might require you to pay for a specific medical service or supply.
Meaning, your health insurance plan may require a $10 co-payment for
an office visit or brand-name prescription drug, after which the insurance
company typically pays the remainder of the charges.
----------------------------------------
What
is a deductible?
A "deductible"
is a certain dollar amount that your health insurance company might
require you to pay out-of-pocket each year before your health insurance
plan begins to make payments for claims. Not all health insurance plans
require a deductible. HMO plans typically do not require a deductible
even though most Indemnity and PPO plans do.
----------------------------------------------------
What
is coinsurance?
Coinsurance is the amount
that you are required to pay for a medical claim, apart from any co-payments
or deductible. Meaning, if your health insurance plan has a 30% coinsurance
requirement (and does not have any additional co-payment or deductible
requirements), then a $100 medical bill would cost you $30, and the
insurance company would pay the remaining $70.
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What
is the difference between in-network and out-of-network providers?
In-network providers are
under contract with the health insurance company to provide services
to plan members for a set pre-negotiated rate. An out-of-network provider
is one not under contract with the health insurance plan. Normally,
visiting a doctor or other provider within the network allows the amount
you will be responsible for paying to be less than if you were to go
to an out-of-network provider. There are some exceptions, in many cases,
services you receive from out-of-network providers will either be paid
less or not paid at all by the insurance company.
Indemnity plans normally
do not make use of provider networks like PPO, POS, and HMO plans.
--------------------------------------
What's
the best health insurance plan for me?
It can be quite difficult
to choose between different health insurance plans. Everyone will have
a different plan that best suits their needs. What is best for you and
your family may be different than the best match for someone else. Here
are a few things to consider in order for us to help you answer this
question:
1) Are you going to need long-term coverage or just something for the
short-term?
If you are between jobs for one to six months, looking into short-term
coverage may be an option for you. If you do not have the option of
receiving group health insurance coverage through an employer, then
you might value the stability and increased benefits offered through
an individual and family health insurance plan which will provide longer
term coverage.
2) Are you looking for basic coverage or more comprehensive coverage?
Basic coverage (meaning primarily inpatient hospitalization and outpatient
surgery coverage) will cover you in case of a major accident or illness.
Basic coverage insurance plans will normally have a lower monthly premium
than plans with more comprehensive coverage, and are generally used
by people who intend to use their insurance primarily in the event of
a serious accident or illness.
On top of offering coverage in case of a major accident or illness,
Other insurance plans offer more comprehensive coverage which often
include benefits such as: preventative care, physician services, prescription
drug benefits and routine office visits. Comprehensive coverage insurance
plans will usually have a higher monthly premium than plans that only
offer basic coverage, and might be best suited for people who intend
to use their insurance on a regular basis.
3) Would you rather pay for your services before you use them or when
you use them?
Normally, the higher the monthly premium you pay, the less you pay per
doctor's visits in co-payments and deductibles. By choosing a health
insurance plan with a low monthly premium, you are more likely to have
a higher co-payment or deductible. If you do not intend on making frequent
use of your health insurance coverage, a higher-deductible plan with
a lower monthly premium might be better suited for you.
4) How important to you is easy access to specialists?
If you prefer easier access to specialists, you might want to consider
a different type of plan because health insurance plans that require
you to get your care through a PCP will also usually require you to
obtain a referral before seeing a specialist.
5) Do you have a specific doctor or hospital that you would like to
visit for healthcare?
It is important to pay close attention to the network of doctors or
facilities that each health insurance plan uses. If you have a favorite
doctor or hospital you will want to check and make sure that they are
included on the list for the health insurance plan you choose. It is
also important to remember that networks used by health insurance plans
can change. Meaning there are no guarantees that your doctor will always
be under contract with your chosen health insurance plan.
6) What is the most you could pay out in case of a serious illness or
injury?
Normally, health insurance plans place limits on how much a member is
required to pay out per year for his or her healthcare. This amount
is often referred to as an out-of-pocket maximum. Once you have paid
this maximum amount toward your healthcare, the health insurance company
will usually cover all other costs for the rest of the benefit year.
You might want to pay special attention to the out-of-pocket maximums
for the health insurance plans you're considering if you are worried
about what might happen to you in case of a serious illness or injury.
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When
can my coverage start?
You can specify that your
Individual and Family health insurance plan start anytime between one
and ninety days in the future. Keep in mind that the insurance company
will usually need some time to process your application so t is important
to remember that the actual date for the start of your coverage may
be different depending on the underwriting process and the availability
of your medical records. (Underwriters will receive your application
much faster if you "eSign" your application.)
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How
can I insure just my child?
If you are getting a quote
for your child enter the child's gender and birth date in the "Applicant"
or first row. Additional children should be entered below in the "Child"
rows, but not the "Spouse" row.
Be advised that many health insurance companies will require one policy
per child. If you have more than one child, enter just one child first
to see a larger selection of plans and prices. You can apply for each
child separately.
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Why
should I shop with you rather than buying an insurance plan elsewhere?
PlanRover uses the local
knowledge of a neighborhood agent along with our experience and detailed
understanding to offer our customers:
• Broad Selection. By being a health insurance agency and not
a health insurance company, we can offer plans from several insurance
companies in your area. We offer a wide selection of health insurance
companies and plans that will allow you to find the plan that is better
suited to your needs.
• Best Prices Because health insurance rates are filed with and
regulated by your state's Department of Insurance the consumer pays
the same monthly premium for the same plan, whether you buy from PlanRover,
your local agent, or directly from the health insurance company.
• By offering several plans that can be submitted and signed electronically,
PlanRover eliminates the need to manually print and mail applications.
This drastically reduces the average processing time.
• Excellent Customer Care. . PlanRover offers licensed and experienced
health insurance agents and representatives ready to help you make the
most of your money with professional, unbiased advice. We believe you
will have a wonderful customer care experience.
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When
I buy an insurance plan, how do I make payments?
When you complete your application
most companies will ask you to provide a credit card number or a check
written to the health insurance company for the first premium payment.
Normally, your credit card will not be charged nor will your check be
cashed until you are approved for coverage. Non-Approval for coverage,
or cancellation of your application, will result in your card not being
charged and any check payment you made will be returned or refunded.
Once approval has been determined, your ongoing premium payments are
paid to your health insurance company typically on a monthly or quarterly
basis. Insurance companies will usually offer several payment choices
including monthly billings to be paid by check or credit card, automatic
bank drafts or automated credit card charges. Please be advised that
credit card billing of premiums is optional and you can obtain coverage
without using that method of payment.
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If
I apply for an insurance plan, am I obligated to buy?
No. You are not under any obligation to buy a health insurance plan
when using our site. After completing and submitting your application
you may cancel it at any time during the underwriting process. When
you submit an application you will usually include your credit card
number, bank account information, or a check for the initial premium
payment. Most insurance companies do not charge your card, debit your
account, or deposit your check until you are approved. If you are charged
or your check is cashed and you are denied for coverage or cancel your
application prior to approval, the insurance company will issue a refund
to you.
There are a few insurance
companies that might charge an application fee. You will be notified
in the application if the plan you chose requires an application fee.
Please note that these fees are non-refundable.
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Do
you offer the best prices?
Because health insurance rates are filed with and regulated by your
state's Department of Insurance the consumer pays the same monthly premium
for the same plan, whether you buy from PlanRover, your local agent,
or directly from the health insurance company. This allows PlanRover
to pass on the savings to you ensuring that you get the best possible
price.
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Can
I contact someone if I need help?
Yes. PlanRover's’ customer care center is staffed with licensed
and experienced health insurance agents and representatives, ready to
assist you with all your health insurance questions. We believe in providing
our customers with the best possible customer service available.
• Call Us
PlanRover has licensed insurance agents and very knowledgeable representatives
that are ready to help you. Just call
Mon - Fri, 6AM-9PM PT.
• Email Us
Please note that our licensed health insurance agents can only discuss
insurance plan benefits and rates by phone. Please Click here to send
us an email. One of our knowledgeable customer care representatives
will reply to you as soon as possible.
• Chat Online with Us
We have an online chat option that is available 24 hours a day, 7 days
a week, not including holidays. Please be aware that we can only discuss
insurance plan benefits and rates by phone.
Health insurance premiums are filed with and regulated by your state's
Department of Insurance. Whether you buy from PlanRover.com, your local
agent, or directly from the health insurance company, you'll pay the
same monthly premium for the same plan. This means that you can enjoy
the advantages and convenience of shopping and purchasing your health
insurance plan through PlanRover and rest assured that you're
getting the best available price.
Because health insurance
rates are filed with and regulated by your state's Department of Insurance
the consumer pays the same monthly premium for the same plan, whether
you buy from PlanRover, your local agent, or directly from the health
insurance company. This allows PlanRover to pass on the savings to you
ensuring that you get the best possible price.
Can I contact someone if
I need help?
Yes. We believe in providing you with top-quality customer service.
Our customer care center is staffed with licensed health insurance agents
and knowledgeable representatives, ready to assist you.
Yes. PlanRovers’ customer
care center is staffed with licensed and experienced health insurance
agents and representatives, ready to assist you with all your health
insurance questions. We believe in providing our customers with the
best possible customer service available.
• Call Us
PlanRover has licensed insurance agents and very knowledgeable representatives
that are ready to help you. Just call Mon - Fri, 6AM-9PM PT.
• Email Us
Please note that our licensed health insurance agents can only discuss
insurance plan benefits and rates by phone. Please Click here to send
us an email. One of our knowledgeable customer care representatives
will reply to you as soon as possible.
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How
does health insurance work?
Health insurance is a plan that customers pay for on a fixed monthly
basis. The plan helps pay for unexpected medical costs at anytime when
needed.
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