Buying an individual healthcare plan can be a stressful experience for those who have always been insured by their company's group insurance. I’ve specialized in helping clients select good medical insurance for well over ten years now and have been an insurance agent for over 20 years. I've outlined the steps we use to help our clients find the right plan.

The three areas we look at are cost, coverage and the strength of the insurance carrier.

Company- Your health insurance carrier should be stable financially and have a history of paying claims.

Quality of coverage - The medical coverage must meet your needs. It should cover doctors, hospitals, labs plus drugs. It should also have physicians and hospitals in their networks that are close to your home and workplace.

Price- Your health care plan must be priced fairly relative to the coverage provided.

The basic process we use is to:

Determine which individual medical companies are worthy of being considered.

Determine which plans offered by those health carriers offer proper coverage

Determine which plans are priced best relative to the health insurance benefits provided

Health Insurance Companies

A personal health care company should have good AM Best ratings and be in good standing with your state’s insurance department. You may also want to do a Google search for complaints.

You might search for "Mega Life and Health complaints" before completing an application with them. Every healthcare provider has some unhappy customers just by virtue of the volume of clients they have. That being said, a red flag should go up in your mind when there is evidence of a pattern.

Another thing to be aware of is how much they pay in benefits as a percentage of the premium they take in. A typical health insurance carrier will write checks for about 80% of the money they take in to cover their clients’ doctors and hospital bills.

Coverage - What does your plan cover?

There are two important aspects of coverage. One is the procedures that are paid for by the plan. The second is the network’s list of hospitals and doctors that the insurance contract includes.

Covered Healthcare Procedures

Your healthcare insurance policy should cover you for physicians and hospitals and the hospital and should have a good lifetime maximum benefit. I suggest at least 5 million dollars of coverage. You should read through your insurance plan’s outline of coverage or official brochure to see how doctors, hospitals and prescriptions are covered.

Insurance Exclusions and Limitations in Medical Policies

Most if not all health care insurance policies will have a list of treatments and services that are not covered. Most of the items in this section are reasonable and are included in the policies of other companies also. Insurance Plans usually will not pay for cosmetic surgery for example. There are are often exclusions that you may discover in one insurance policy but not in others. Maternity insurance is one example of this. Generally insurance plans will not cover the costs of a normal pregnancy. The ones that do will be more expensive when compared to otherwise similar plans that don’t cover maternity. The exclusions and limitations section of your policy or its out line of coverage should be read carefully before you commit to purchasing any health insurance plan.

Healthcare Insurance Provider Lists

Knowing which physicians and hospitals are in your health insurance carrier's network is important. You might be able to find a list of doctor’s who accept a given insurance plan online or by calling your health insurance agent.

Price – Finding the best low cost healthcare policy

It is easy to compare private health insurance premiums, but its much harder to make sure you're getting good coverage for your money.

Comparing Healthcare Insurance Policies

When you have eliminated the bad insurance companies and have eliminated the plans offered by those companies that don’t meet your needs, you are ready to compare plans and prices.

The Best Medical Insurance Coverage for the Money

The best health insurance coverage, may not be the best plan for you. Often the best plan is overpriced and does not offer coverage that justifies the extra that it costs. Make sure that any plan you decide to own is:

Provided by a good medical insurance carrier

Will cover your health care needs well

Is priced well for the health care benefits it provides