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Commercial Health Insurance

With the expense of health care, no one can afford to be without health insurance. Unfortunately, despite the fact that the cost of health care well exceeds the cost of commercial health insurance, millions of Americans continue to live without health care, believing that they cannot afford it or even that they do not need it. With the cost of a doctor’s visit exceeding a hundred dollars just for a regular check-up and the average cost of a five-day stay in the hospital being nearly $10,000 not including the cost of surgeries, it is becoming more important to search around and purchase low cost health insurance.

What is Commercial Health Insurance?

Perhaps in order to understand why you need commercial health insurance you need to understand what it is. Commercial health insurance is also known as private health insurance. (For the purposes of this guide, we are not covering the needs of businesses to purchase coverage for their employees, which is also referred to as commercial insurance.) This is any insurance that is not paid for by the local or federal government.

This could be insurance that you receive from your employer or that you pay for out of your own pocket. While there are varying commercial health insurance plans available, they all fall under the same category because they are paid outside of government plans. This means that any coverage such as Medicare, Medicaid, Veteran’s benefits, and your local children’s programs are not commercial health insurance.

Types of Commercial Health Plans

As mentioned before, there are several different commercial health insurance plans to choose from and they can be broken down into these four categories:

  • Indemnity or Traditional pay per service plans
  • Health Maintenance Organizations (HMO’s)
  • Point of Service (POS) Plans
  • Preferred Provider Organizations (PPO’s)

Which commercial health plan is best for you? Read on to learn some of the specifics about how each plan works.

Indemnity Plans

Indemnity plans offer you the most flexibility amongst insurance plans; however, they are often the most expensive as well. Indemnity plans can provide you will full comprehensive coverage or you can choose only certain types of coverage, such as hospital coverage, which is a great benefit for someone who has limited coverage through work, for example, and only needs specific coverage to provide them with complete coverage. You can reduce the cost of indemnity plans by increasing your deductible. Indemnity coverage is very appealing because you can choose any doctor, specialist and hospital that you want; there are no limitations or lists to choose from. However, watch out for some types of indemnity health plans that while very affordable only offer very limited coverage.

HMO Plans

HMO’s are probably the most affordable types of commercial health insurance. HMOs offer comprehensive coverage but in a very restrictive way. You are required to choose your primary care physician from a list of doctors and you can only see a specialist if your primary care physician provides you with a referral. Any specialist that you need to see would have to be on the HMOs preferred list as well, which can limit your choices dramatically. HMOs rarely, if ever, have deductibles and a small co-pay is usually required to be paid at the time of service.

POS Plans

POS plans are very similar to HMO’s; however, they offer more flexibility than a HMO does. Still much less expensive than an indemnity, a POS plan will cost more than an HMO; however, not by much. Additional flexibility is offered with a POS plan because although you are required to choose a primary care physician from a list, you still receive coverage should you deviate from the list.

In most cases, you will pay a small deductible for your doctor that is not on your plan and then being to receive a certain amount of reimbursement for the services that you receive from your doctor. In essence a POS negotiates what they consider a fair price for services from the doctors on their list, should you use a doctor not on the list, you will pay the difference between what they perceive is a fair price and what your doctor actually charges.

PPO Plans

The PPO plan is very similar to the POS in regards to doctor choice. However, with the PPO plan you are not required to choose a primary care physician. Instead, you are giving a list of doctors who charge the rate your PPO is willing to pay and you can see them or choose to visit a doctor not on the list and simply pay the difference. You also have the flexibility with a PPO to see a specialist without a referral (again, you are given a list but are not required to stick to the list). Some perceptive patients negotiate with their current doctors to accept reduced payment so they do not have to pay more out of their own pocket.

Compare Commercial Plans

As you can see, there are many different types of commercial health insurance plans to choose from. These choices may bring up a lot of questions for you and if that is the case, take a moment to call one of our independent agents and get your questions answered quickly and correctly. Do not guess at the answers, let a professional help you so that you can make the right choice for your health insurance.

Ways To Manage Your Costs

In order to find affordable rates for your policy you can opt for higher deductibles and co-pays in order to obtain lower premiums. Just make sure that of your ability to pay these costs before agreeing to any plan. When reviewing quote options from companies, be sure that you understand what each is offering you in these areas.

Another way to manage your cost is to look at private and company sponsored plans. Different ones have different cost benefits depending on the company plan and your health needs and situation. Private plans can be beneficial for healthy people who don’t want to take on the added costs of high risk members in a group pool.

Finally, actively managing your health by not smoking and controlling your weight will directly impact the rates you are offered. While some changes to health may not show results immediately, your lifestyle choices usually have a result on the prices you pay for coverage.

Compare Commercial Health Insurance Quotes

If you have already done all of your research and you are in a place where you want to know how much your choices are going to cost, then use our free quote tool at the top of the page and compare the costs of reputable health insurance companies side by side instantly. Knowing how much your plan will cost is the first step to finding affordable commercial health insurance for you and your family. Everyone needs insurance at some point in their life. Make sure that you have the protection that you need. Why not get some quotes now?

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