Florida health plans for individuals under 65 are, by and large, PPOs. PPO stands for Preferred Provider Organization. PPOs are networks of healthcare providers who have accepted negotiated contracts within a Florida individual health plans network. These various providers must accept the fee schedule as outlined in the contract. Your healthcare provider choices will be up to you, but there are financial incentives if you select providers within your Florida health plans PPO network. In certain areas (for example Miami), you can find a company that offers an HMO. If you don't live in South Florida and want an HMO, you will most likely need to be a business owner and set up a group plan through a corporation. We can help you with that as well.
Florida individual health plans PPO's generally require you to take a deductible. A deductible is the dollar amount you’ll be required to pay for healthcare expenses before your insurance carrier will begin to cover your medical bills. Some carriers offer deductibles as high as $25,000, and if you wish to take on that kind of risk, you will be rewarded with a low monthly premium. Deductibles commonly range between $500-$5000 and can be selected with or without copays for Doctor visits. If you pick the most competitive insurance company within your zip code, you can receive a lower deductible for your healthcare dollar.
What a Copay is as It Pertains to Florida Health Plans
RTC Insurance Advisors often has to answer questions from clients during a consultation regarding clarifications revolving around the Florida health plans coinsurance. If you are currently unaware of what coinsurance is, we will explain this to you now. There is a difference between the terms copay and coinsurance. Copays are a cost-sharing arrangement in which you will be responsible for a specific charge for a specific medical service (for example $20 per office visit, or $10 per generic prescription). Florida health plans offer copays. On average, it will be $35 for a primary visit and $50 for a specialist visit.
Coinsurance is the split amount you will be required to pay for a particular medical service after the deductible is satisfied. Coinsurance is measured as a percentage of a portion of a medical bill (for example 80/20). Good Florida individual health plans do not require you to pay 20% of the total bill. There is, in fact, a point where you are no longer required to pay on a Florida health plan. This is called a stop-loss. After you satisfy your deductible, you must pay your portion of coinsurance up to a certain amount. Your stop-loss will vary depending on which plan you chose. Call or email us and we will inform you of the specific financial features of the most competitive Florida health plans that fit your healthcare needs.
Of course, there are more components to a health insurance policy. For instance; annual maximums, preventive care, and prescription Rx coverage to name a few. We at RTC Insurance Advisors will elaborate on what we just discussed here and add to these points to make you a better consumer of Florida individual health plans from this point forward. When you know what to look for in a plan, finding a new policy is fast and easy. We hope to hear from you soon.
By Robert Colucci
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