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Health Insurance In Florida Basics

For individual plans, South Florida Health Insurance  has a varied array of both plans and carriers to choose from.  Depending on your age, sex and health status; choosing the right plan and price can be extremely confusing.  Many people believe that the most popular carrier (such as Blue Cross Blue Shield) may be their best option but depending on the type of coverage they want be it an HMO or a PPO your easiest option will be to determine a few things ahead of time.

Deductible:

This number represents the amount you need to spend prior to benefits kicking in.  Depending on the plan and carrier, this number may only pertain to hospital admissions or special testing but with some of the lesser discount carriers it can apply to any type of medical treatment.  Deductibles can range from 0 to as high as $5,000 and depending on how much you want to spend each year in addition to your premiums this should be a fairly important factor in choosing your plan.

Co-Payment:

The amount paid to doctors and emergency rooms for routine visits or checkups as well as for medication at the pharmacy.  Generally a co-payment for routine medical care will range from $10 – $50 and won’t be subject to a deductible.  Carriers such as BC/BS and Goldenrule/United Healthcare can have a single co-payment although as a rule you will have one payment for your Primary Physician and one for Specialists.  A high co-payment can be manageable as long as you aren’t also subject to a high deductible as the difference in premiums to lower your co-pay might not always be worth it if you visit your PCP once or twice a year.

Co-Insurance:

Coinsurance is a percentage that the insured pays after the deductible is met up to the policy’s deductible or stop-loss.  Usually it is expressed in a percentage such as 80/20 which means that the carrier will pay 80% and you will be responsible for 20%.  Most plans come with a stop loss limits of $1,000 to $3,000 after which the insurer covers the rest. Co-insurance is found most often on PPO provider’s plans although some carriers such as Vista offer HMO plans with coinsurance.

An East Coast Licensed Health Insurance agent is prepared to help you wade through these options and help you find the best plan for the best price.  We pride ourselves on representing the most amount of providers and each of our agents is armed with the necessary information to help you get the best coverage possible for you and your loved ones.

Call  us today! 1.888.803.5917


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