Download Your AARP Personal Guide to Buying Health Insurance PDF

TitleYour AARP Personal Guide to Buying Health Insurance
File Size1.1 MB
Total Pages15
Document Text Contents
Page 1

Your AARP Personal Guide to Buying Health Insurance

What you should know.

BA9802 (3/06)

Page 2


A word from AARP
Health Care Options®

AARP Health Care Options is happy to offer you this personal guide to

buying health insurance. We are committed to being a source of user-friendly

health information for people age 50 and over Ñ and to making products

available that can help you stay healthy. Even if you donÕt purchase health

insurance through AARP Health Care Options, we want you to make an

informed decision, for your own good health.

Buying health insurance can be confusing, so this guide will help you

understand some of the issues involved. YouÕll find questions to ask

insurance companies before you buy, as well as a glossary of insurance

terms. Throughout, youÕll also find the story of Alice, someone who needs

to buy her own health insurance for the first time. We hope her story will

give you insight on how to purchase individual health insurance.

AARP Health Care Options is the name of AARP’s health insurance and service program. It is not
the insurer.

Table of Contents

Starting Out Page 2
Coverage Page 3
Pricing Pages 4–5
Research Checklist Page 6
If You Can’t Qualify Page 7
Comparison Worksheet Pages 8–9
Glossary Pages 10–11
Notes Pages 12–13

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Now that you understand a little bit more about how individual health insurance works, it’s time
to start looking for a policy. These questions and the worksheet on pages 8 and 9 can help you find
the right balance between coverage and cost.

Find the best coverage and
plan for your needs.
How’s your general health?
If you tend to get sick a lot, look for a plan that
covers doctor’s visits and prescription drugs.
Do you have a doctor or hospital
you prefer?
If you choose a PPO or HMO, make sure those
providers are in the insurance plan’s network.
Do you regularly take any medications?
A plan that covers prescription drugs can help.
Add up your annual prescription costs to
determine if the plan will meet your needs.
Is preventive care important to you?
Your annual checkup, blood work,
mammograms, and other diagnostic tests are
more likely to be covered under a comprehensive plan.

How you can keep costs down.
Are you in great health and want a lower monthly bill?
A catastrophic plan with limited coverage may be the right choice —
just remember you’ll probably be paying for all of your preventive care
yourself. And if your medical needs change later on, you may not be eligible to change to
a comprehensive plan.
Would you be willing to go with a higher deductible to save money?
Some people would rather pay a higher monthly premium to avoid a big deductible payment.
Others would rather pay less in monthly premiums because they have the cash reserves to afford
a substantial deductible.
Are you willing to use network hospitals and doctors to save money?
Consider a PPO (which gives you a choice between network and non-network providers) or an
HMO (which may limit you to network providers only). Remember, with an HMO, you may have
to get a primary care physician’s permission first (a referral) to see a specialist (see the Glossary
on pages 10 and 11 for more on HMOs).

ÒI have to think of the future.Ó

ÒI have quotes from two insurance companies,Ó

thought Alice.ÒIÕm on a tight budget, but the plan

with the lower rate doesnÕt offer prescription

drugs or preventive care. I could get the low rate

for a year Ñ then switch Ñ but what if I get

sick? Then other insurance companies might not

accept me. Sure, IÕm healthy now, but if I get sick

down the road I may

want that kind

of security.Ó

4. Your research checklist

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5. What to do if you can’t qualify


Alice did her homework.

As she compared plans,Alice thought,“I want a plan that is

affordable and offers me the coverage I need so that I can stay

healthy while I focus on my new business.”Alice looked at plans that offered comprehensive

coverage so that her allergy shots, asthma prescriptions, checkups, and routine doctor’s

visits would be covered. She reviewed the premiums, deductibles, co-pays, and co-insurances,

as well as exclusions for pre-existing conditions. After careful consideration, Alice ended up

choosing a plan that cost her a little more but gave her the benefits and security she really

wanted. She thought,“Now that I have my health insurance taken care of, I can start

working on my future.”

If you’re having trouble finding insurance because of a pre-existing condition, the Health
Insurance Portability and Accountability Act of 1996 (HIPAA) may help. HIPAA laws vary
from state to state, but many states restrict the ability of insurers to exclude pre-existing
medical conditions from coverage if you were previously part of a group plan, paid your own
premiums for COBRA coverage, and applied for new coverage within 63 days after having left
the group plan.To learn more about the HIPAA regulations for your state, visit

Use the Comparison Worksheet on the next page
to start exploring your coverage options. >

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P.O. Box 1017
Montgomeryville, PA 18936-1017

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