Individual health insurance plans are available for those who aren't covered by your employer's group health insurance. There are two types of individual health insurance plans: managed care plans (HMOs, PPOs, and PPOs) and indemnity (fee for service).
The main differences are in how bills are paid, who the providers are, what out-of-pocket costs can be incurred, and which healthcare providers they choose. Indemnity plans typically require individuals to pay a percentage (called co-insurance), and the insurance company will pay the rest. You can find the best individual health insurance in Virginia online.
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An 80/20 plan is a common indemnity plan. The insurance company pays 80%, and the insured pays 20%. Your insurance company will pay only the "usual customary, reasonable, and reasonable" fees. These fees are determined based on the cost of a service in your area by health care providers.
If your individual health plan has a minimum deductible, you must meet this first before the pay structure kicks in. You may need to pay upfront for services and then submit claims to the insurance company to get reimbursement. This is in contrast to having your provider bill your insurance company directly for services.
Indemnity individual plans offer a lot of freedom when it comes to choosing your provider and the medical facility you choose, but they are not cheap. The amount of your deductible and your out-of-pocket limit can affect the cost.