Individual and Family Health Insurance

Individual (non-group) medical plans provide hospital, surgical, medical, and accident insurance. Most plans have a deductible ($250-$10,000) after which the plan pays 70%--100% (depending on the plan) of your covered medical expenses up to a stop-loss limit (usually $5000 or $20,000) then 100% up to the policy maximum per person of $5 Million or more.

Most plans are PPO plans and 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 these benefits are not subject to the plan deductible;  they are paid 100% after a co-payment.

It is important to consider the PPO (Preferred Provider Organization) network of providers.  Is your doctor or hospital in the network?  Blue Cross companies generally include 95% of  all healthcare providers.

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 (Health Savings Acoounts) plans are a newer concept  .Premiumsare often lower 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).

Both Anthem Blue Cross and Blue Cross of Illinois HSAs feature first-dollar preventive benefits.  This means that cerain routine wellness proceedures are paid for without meeting the deductible.