Individual - Family - HSA Plans

Individual (non-group) medical plans provide hospital, surgical, medical, and accident insurance. Most plans have a deductible ($250-$5000) after which the plan pays 80% of your covered medical expenses up to a stop-loss limit (usually $5000 or $10,000) then 100% up to the policy maximum of $5 Million or more.

Many PPO plans include doctor office visit co-pays, Rx prescription drug card (brand and generic), and wellness coverage. With such plans, you may consider the higher deductibles because you do not need to meet the plan deductible for doctor visits or Rx coverage; they are paid 100% after a small co-payment.

The cost of individual plans generally is directly related to the benefits they provide and the deductible and coinsurance (percentage you pay). Another factor, of course, is your age and health conditions. Smokers, those overweight, and/ or with pre-existing medical conditions will pay more-or may even be declined for insurance. Individual plans are medically underwritten.

HSA plans are a new concept. Generally, they offer lower premium (because of the high deductible). An HSA has two components: (1) A qualified high deductible health insurance policy. (2) An individual savings account with tax advantages; the savings account can be used to pay for most medical expenses on a tax-free basis, or left to accumulate with interest tax-deferred. Your annual savings deposit is a tax deduction (similar to an IRA).