Covered California
Certified Agent

What Are the Common Benefits of Individual Health Insurance Plans?

Getting individual health insurance can help you live a stress-free life. Once your policy is active, you won’t have to worry as much about accessing healthcare services when you need them most. But what benefits do most individual health insurance plans have in common?

Here’s a look at four reasons why you should get individual health insurance.

Affordable Maternity Care

One of the main benefits many individual health insurance plans have in common pertains to maternity care. Several medical insurance policies like the Ambetter Bronze 60 PPO plan provide maternity services at just 40% of the total out-of-pocket costs provided the policyholder visits a preferred medical facility.

There are also plans with higher premiums, like the Sharp Platinum 90 HMO, that offer holistic maternity services, including pre-natal/post-partum visits, professional delivery services, and maternal counseling at zero cost. All you’ve got to do is stay current on your premium payments, and you won’t be charged out-of-pocket.

Pediatric Services

Children often incur substantial medical costs due to things like CDC-mandated vaccinations. This is why it’s common for parents to take out individual health insurance plans that provide coverage for pediatric services.

For instance, if you take out a Sharp Bronze 60 HMO Performance plan, you’ll be entitled to complimentary children’s eye exams, glasses, and dental checkups, provided you visit a pediatric clinic within Sharp’s preferred network. The Minimum Coverage Ambetter PPO plan provides the same benefits.

A mother bumping noses with her child

Readily Available Specialist Consultations

Did you know there are two kinds of individual health insurance plans? HMO plans allow policyholders to see doctors in the area where they live/work, while PPO plans allow visitations at any medical facility within the provider’s network. Why is this important? Because most PPO individual health insurance plans provide round-the-clock availability for specialist consultations. In simple words, if you’ve been advised to see a specialist for a medical condition, taking out a PPO health insurance plan is a great way to book a consultation without being put on a waiting list.

For instance, the Blue Shield California Silver 1750 PPO plan covers everything from specialist care office visits to advanced radiology imaging such as MRI. If you’re on this plan and have to see a specialist, you’ll have the option of seeing any specialist for your condition within the preferred partner network. Moreover, if there aren’t any specialists available via physical appointment, you can book a Teladoc appointment for free.

Remedial Mental Healthcare

Mental health issues impact a fifth of adults in the country each year. In California, over 5.5 million adults suffer from mental health issues—yet only half of them receive treatment. Fortunately, there is a myriad of individual health insurance plans that provide coverage for mental health issues.

One of our favorite medical insurance plans for holistic mental health coverage is the Ambetter Gold 80 PPO plan. This plan provides 20% off in-patient visits to medical professionals specializing in mental and behavioral health. It also gives policyholders access to specialty prescription drugs (some of which are used to treat mental health conditions) for 20% off the regular cost of up to $250 per script.

It’s tempting to think the extent of mental health coverage you get purely depends on how big your health insurance premiums are—but that’s not the case. For example, the premiums charged for the Sharp Platinum 90 HMO Premier plan are lower than the Ambetter Gold 80 PPO plan. This is why the former only offers a 10% discount on health services and coverage is restricted to the area the policyholder lives/works in. Yet despite the lower premium, the Sharp plan covers many mental health services the Ambetter plan doesn’t, such as emergency psychiatric transportation.

Therefore, it’s important to speak to an insurance agent about what type of individual health insurance plan to take out. Failing to do so could cause you to forego a plan for one that’s more expensive and offers fewer benefits.

Covered California Certified Agent Helps Clients Understand the Nuances of Individual Health Insurance

A doctor with a stethoscope around her neck

Now that you know some of the common benefits of individual health insurance plans, it’s time to pick a provider—but which one’s worth choosing? Our insurance agents at Covered California Certified Agent will help you find out.

We provide comprehensive advice on the coverage and cost-effectiveness of various individual health insurance plans. We also assist businesses in taking out employer group insurance and help our clients apply for dental insurance plans that suit their budgets.

Consult a reputable insurance agency in California on medical insurance services by dialing 800-771-7653.