How to Choose the Best Individual Health Insurance Plan from Blue Shield

Having continuous health coverage is very important and can save you from being declined when you decide to switch providers. There are many situations whith clients who decided to let their policies cancel and saw themselves uninsurable, which was just devastating. So, as a first advice, do not let your current policy lapse before applying for a new one. Get a new plan submitted at the beginning of the last month of your current policy, as underwriting can take up to one month.

That Blue Shield’s “Active Start” plan is a great one, with no deductible you get the coverage up front. The Coinsurance is the percent that the Insurance Company pays. So that 60% is what Blue Shield will pay, you pay 40%. That plan has a low co-pay of $25. This plan is an Individual plan, meaning that any other family members would have his/her separate policy. The co-pay is quite low for a PPO plan; only on the HMO plans will you see such a low office visit co-payment as $10 or on an Group/Employee sponsored plan (which are quite expensive!). Most plans offer just a discount for office visits or $40 co-pay.

Another main feature in health plans to look at is the “Out Of Pocket Maximum”. This is truly the whole point to having the Health Insurance; it is the most you will pay in a calendar year for any/all medical services. This means that, God forbid something major were to happen (or many smaller incidents), and for example added up to $1 million, the most you would pay is the Out of Pocket Maximum. On that Active Start plan it is $6000. That is less than the standard amount (usually around $7,500), but there are plans that have $3500 or $4000 which is of course better.

On these Health plans, there is always a give/take, where they GIVE, they TAKE away. For example that Active Start plan has no deductible and a nice office visit and generic drug co-pay, but the out of pocket maximum is higher. For a plan that limits the office visits at a co-pay or have no flat co-pay, but just a discount, the out of pocket maximums are usually lower. So basically it is whatever is most important to you. For those who are healthy and rarely use the office visit, usually for an annual check-up or because they got a cold/flu, the monthly cost and the “out of pocket maximum” are the most important factors to look at.

Resource: getUinsured.com