Individual Health Plans

While evaluating your options for individual health care plans, you'll find that the individual health market ultimately offers the same plans as the group market. Your choices include HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), POS (Point of Service) and traditional Fee for Service plans. Your financial situation, physician preferences, and particular health care needs will all be factors when considering the various individual health plans.

PPO Plans

A Preferred Provider Organization (PPO) plan is considered traditional health insurance and the most commonly known type of individual health insurance. If you choose a PPO plan, you will select the doctor or hospital you want from a list of acceptable choices created by your insurance company. These preferred providers have agreed to accept your insurance as a full payment, after you pay your deductible or copay. If you choose to see a physician who is not in the preferred provider network, you will need to cover a larger portion of the cost. Generally speaking, a larger deductible translates to a lower premium.

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HMO Plans

Health Maintenance Organization (HMO) plans will require you to have a primary care physician from whom you will have to get permission to see any other doctor. HMO individual health plans are often less expensive than traditional plans, therefore your primary care doctor may be less likely to refer you to a specialist unless he or she feels it is absolutely necessary. If you choose to see another doctor without authorization, you will probably have to pay for it out of your own pocket. One popular benefit of an HMO plan is an inexpensive copay, often $10 or $20 for an office visit.

Indemnity or Fee for Service Plans

Current indemnity (Fee for Service) plans are designed to pay you or the hospital in the event of illness or injury. A fee schedule will illustrate how much will be paid for each day you spend in the hospital, and how much will be paid for other health care expenses. While indemnity plans are not usually considered creditable coverage, they are a very inexpensive choice for an individual health care plan.

POS Plans

Point of Service (POS) plans offer members more freedom at greater expense. If you choose a POS individual health care plan, you will receive the highest benefits when using providers who are included in the insurer's network. You also have the option to self-refer to a provider who is not in the network, but your benefits will not be at a level equal to that of using a network physician.