Virginia Individual Health Insurance

Simply Put, Health Insurance is protection against medical costs. A health insurance policy is a contract between an insurer and an individual or group, in which the insurer agrees to provide specified health insurance at an agreed-upon price (the premium). Depending on your policy, your premium may be payable either in a lump sum or in installments.

Health insurance usually provides either direct payment or reimbursement for expenses associated with illnesses and injuries. The cost and range of protection provided by your health insurance will depend on your insurance provider and the particular policy you purchase. If your employer does not offer a health insurance plan, you may wish to purchase health insurance on your own. The Deductible is the yearly amount an insured must pay out-of pocket before insurance coverage begins. The Copayment is a portion of a single medical bill, expressed in a dollar amount, the insured is responsible for paying. The Coinsurance is a portion of a single medical bill, expressed as a percentage, the insured is responsible for paying. The Premium is the monthly amount an insured pays the Insurance company to keep the policy in force. Some choices are:

HMO (Health Maintenance Organization)

A managed care plan in which its members must recieve care for the network of doctors, hospitals, and other care providers. They must choose a Primary Care Physician (PCP) from the network to be the first line of defense, and to provide referrals to specialist care.

PPO (Preferred Provider Organizations)

A managed care plan in which its members have insurance coverage with IN and OUT of network doctors, hospitals, and other health care providers.

POS (Point of Service Plan)

A managed care plan that combines the benefits of an HMO and PPO. Like an HMO, POS plans require members to choose a PCP. Like a PPO, they provide coverage with any IN or OUT of network healthcare providers.

HDHP (High Deductible Health Plan)

Plans with deductibles of at least $1,100 for individuals, $2,200 for families. Enrollment makes you eligible to open a Health Savings Accont.

HSA (Health Savings Account)

A bank account where TAX-FREE income can be saved for health care expenses. Each year unused funds grow with interest.