Individual Health Insurance – What Types of Plans Are Available Under the Affordable Care Act?

Individual Health Insurance – What Types of Plans Are Available Under the Affordable Care Act?

The Affordable Care Act has made changes to individual health insurance plans. This article will describe the new types of individual health insurance plans available and what they entail. Read on to learn more about HMOs, Indemnity plans, and Preferred provider organization (PPO) plans. This article will also discuss the benefits and limitations of each type of individual health insurance plan. By the time you’re finished reading, you’ll be an expert on individual health insurance.

Affordable Care Act changes availability, cost and benefits of individual health insurance plans

The Affordable Care Act (ACA) changed the availability, cost and benefits of individual health insurance policies. It added new protections for people with preexisting conditions and limited insurers’ ability to discriminate based on health status or gender. Among other changes, it created a new guarantee-issue provision for insurance plans and limited insurers’ ability to set premiums based on age and gender. And the law also made it illegal for insurers to reject individuals based on their health status.


There are several benefits to HMOs for individual health insurance. In most cases, they include predictable cost sharing and administrative ease. There are also restrictions on the choice of providers. Participants are entitled to care from healthcare providers within the HMO’s network. In return for a monthly premium, they pay a copay at the time of service, typically $10 to $30.

The rest of the health care cost is covered, and most HMOs use capitation arrangements to reimburse physicians.

Indemnity plans

An individual health insurance indemnity plan is a product that pays for medical expenses incurred by the policyholder. These plans are generally less expensive than traditional health insurance plans. For example, a high-end fixed indemnity plan may provide a $5,000 benefit per day for hospitalization and a $10,000 benefit for surgery. These amounts are far less than the total medical bill incurred by an individual if no health insurance is available. This is important to note since many people are unaware of their high medical costs if they don’t have coverage.

Preferred provider organization (PPO) plans

Using a Preferred Provider Organization (PPO) plan for your individual health insurance can save you money. These plans usually require you to use providers in the network. You may need to pay a copay or deductible for out-of-network care, and you may have to file a claim to get reimbursed later. The benefits of this plan are many, but you need to weigh the downsides.

Coverage that includes a doctor

When you’re looking for individual health insurance coverage that includes a doctor, you need to know about the different types of plans available. Some plans allow you to visit any doctor you wish, while others limit you to specific providers. A good plan will provide you with a list of doctors that you can visit. You’ll also need to know whether your policy covers preventive care. Preventive care is typically covered for free under most plans, though some may be limited to emergency care or catastrophic coverage. Another thing to look for in a health insurance plan is whether it covers specialists. For example, a PPO may not cover acupuncture visits or chiropractic care.

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