Individual Health Insurance
Carrying health insurance is not only the smart thing to do, it’s now also the law.
If health insurance is not offered through your employer, or your employer’s plan doesn’t cover what you would like it to, you will need to get an individual health insurance policy. Phillips Stafford Insurance Group works with all the major health insurers in the state of Iowa as well as the most prominent health insurers in several other states. We can help you navigate the new laws and help you chose the best health insurance policy for your needs and your budget.
Under current law, individual health insurance policies can only be purchased during qualifying events or during the open enrollment period. Because of these restrictions, it’s best that you contact us as soon as possible to make sure you don’t miss an important deadline that could cause you to go as long as a full year without health insurance.
Our Health Insurance Partners
Common health insurance terms
As you shop for health insurance, it’s important to know what you are getting. Below are some common health insurance terms to help you during your search. As always, if you have any questions on any of these terms, give us a call and we can help.
- PPO – PPO, or Preferred Provider Organization, is a term to describe the network of the health insurance plan. A PPO plan is usually the most comprehensive plan and will likely cover the most doctors and hospitals. These plans are also usually the most expensive
- HMO – HMO, or Health Maintenance Organization, is another term to describe the network of the health insurance plan. A HMO plan usually has fewer doctors and hospitals in the network. The insured must also select a Primary Care Physician (PCP) from the network that they will need to visit for minor health concerns. The PCP would then refer the insured to in-network specialists, if needed.
- HSA – HSAs, or Health Savings Accounts, are bank accounts that can be set-up by clients at participating banks to be used to pay qualifying medical expenses. Funds can be deposited into these accounts, up to a limit set by the government, pre-tax. In order to qualify to open the bank account, and receive the tax break, the client must be enrolled in a HSA-qualified health insurance plan, often called a “High-Deductible Health Plan (HDHP)”. These health insurance plans are very simple. They normally require the insured to pay 100% of their medical costs up to a chosen limit. The plan then pays 100% of all charges over that amount.
- Co-Insurance – A plan’s co-insurance is the amount the policy holder will have to pay for medical costs. This is often reflected as a percentage. Assume a policy has a $1,000 deductible, a $5,000 out-of-pocket max, and a 20% co-insurance. If the policy holder has hospital bills of $100,000 the policy holder would pay the first $1,000 (deductible). They would then pay 20% (co-insurance) of the remaining $99,000 until the policy holder has reached $5,000 total (out-of-pocket max).
- Out-of-Pocket Max – This is the most a policy holder will be required to pay in any calendar year for medical expenses, not including premiums and co-pays.
- Co-Pay – This is the amount a policy holder must pay for select coverages on a policy. This is commonly used for prescription drugs and office visits. Co-Pays rarely reduce the annual deductible or out-of-pocket max owed by the policy holder.
Other Health Insurance Policies
Looking for dental or vision insurance? We can provide that as well. We have access to several competitive dental and vision insurance programs. These coverages are often included with group health plans but less common on individual plans.
Need help with providing health insurance to a group? Click here.
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