Choosing the best health care policy is a decision that can keep a person up late at night since there are so many different policies and companies on the market today with many different unfamiliar terms to try and understand so that the best decision can be made. In addition, there are different factors that need to be addressed for families who take care of an elderly parent, versus a couple who is thinking about having a baby for the first time. All of these factors have to be kept in mind and thoroughly addressed in order to choose the right individual health care policy for that family.
Often one individual's place of employment will offer a health care policy for their employees. Usually these group health care policies have minimal choices that the person can make beyond how many people will be insured under that policy. These policies are nice in that they are usually less expensive to begin with, in addition to the employer paying part of the premium sometimes as an incentive for the individual to use the group health plan.
Individual health care policies do not have to fall under these group health plans, but even if the policy is a private policy, they can still fall under a managed health care plan such as an HMO, PPO or POS. An HMO is the most restrictive individual health care policy in that the individual must choose providers from a particular list that is approved by the HMO in order to have the service covered. Also, in order to go to a specialist, the individual must get his primary care provider to refer him to the specialist; otherwise he cannot go and have it covered by the HMO.
A PPO or a POS gives the individual more of a choice in providers under the individual health care policy, although in order to get the best coverage and least out of pocket expense, the individual still has to choose from a list of approved providers. However, if the individual does not go to a provider from the list, the PPO or POS still pays a portion of the claim, although it is not as much as it would have been with an approved provider.
Indemnity individual health care policies provide the most choices for a provider, but the premiums are usually higher than the managed health care policies, which can be restrictive to some individuals.