Health Insurance Primer for eBay PowerSellers

We understand that applying for health care coverage on your own can be very complicated. Below is a list of plan types as well as some terms you will see throughout the application process. Understanding these plan types and terms will help you make informed decisions about health care for you and your family. Please note that not all plans are available in all states.

High-Deductible Plans
High-Deductible Plans are ideal plans for individuals willing to take additional responsibility for routine health care expenses in exchange for lower premiums. The deductible would normally range between $1,000 and $5,000 in order for it to qualify as a high-deductible plan. These are the most popular and affordable plans for individuals at this time.

Health Savings Account (HSA)
Health Savings Accounts are an excellent choice for individuals and families who want to control their health insurance costs by combining a lower-cost high-deductible insurance plan with their own tax-advantaged savings account. The money placed in the tax-favored savings account can then be used to pay the deductible, or pay for other qualified medical expenses. Plus, the unspent money in the health care savings account roll over year after year; you won't lose what you don't spend by the end of the year.

Copay Plans
Copay Plans are designed for individuals and families who prefer the convenience of copay benefits for routine health care expenses. These plans normally have lower deductibles but higher premiums.

Saver Plans
Saver Plans provide inpatient coverage and coverage for only the most costly outpatient health care expenses, such as surgery, CAT scans, and MRIs.

Select PPO (Preferred Provider Organization) Plans
Select PPO Plans provide high quality care for the lowest premium by accessing a defined network of respected physicians and hospitals. This doctor and hospital PPO offers savings on every visit to any network provider.

"Any Doc" PPO Plans
“Any Doc” PPO Plans provide the flexibility to choose your own physician while saving money with the preferred rates of our prominent nationwide hospital network.

Managed Indemnity (Fee-for-Service) Plan
Managed Indemnity Plan offers you comprehensive major medical coverage with the flexibility to select the doctors and hospitals of your choice. Sometimes referred to as an 80-20 plan.

Premium
Premium is the amount an individual will have to pay each month for health care coverage.

Deductible
Deductible is the set amount of money an individual will have to pay each year before the insurance policy starts to pay. Typically, the higher the deductible, the lower the premium.

There is no question that premiums for health insurance can be very expensive. For that reason many insurance professionals believe a person should consider being insured for the catastrophic losses and pay for incidental medical expenses out of your own pocket. This follows the fundamental principal of risk.

You will find premiums get lower as you consider higher deductibles. Our experience shows that most individual medical plans sold today utilize a deductible of at least $1,000. It is not uncommon to see people enroll in plans with deductibles as high as $5,000 for the purpose of keeping premiums as low as possible.

It is understandable there are more out-of-pocket expenses associated with high deductible plans. Incidental medical expenses such as doctor’s office visits and prescriptions are bound to come up in anyone’s life. For that reason, you may want to consider purchasing an additional insurance product called Hospital Indemnity. This product provides coverage for certain medical related expenses according to a schedule of benefits.

Whether you choose to apply for the Hospital Indemnity plan or not, you may want to take advantage of the Rx/Health Discount Card. For anyone enrolled in a high deductible individual major medical plan, this card can help you stretch your premium saving dollars. This card is not an insurance product; rather, it provides you with pre-negotiated discounts for such things as prescriptions, dental, vision and more.

Let’s take a look at how this approach might work for a male, age 35 living in St. Louis, MO: