License# 709244
715 Kensington, Suite #10
Missoula, MT 59801
Office: 406-543-8371
Fax: 406-728-2410
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About Health Insurance
What is the major difference between group and individual insurance?
The major difference between group and individual health insurance involves evidence of insurability. To purchase individual insurance, a person must generally answer a health questionnaire and undergo a medical examination to provide evidence of insurability to the insurance company. An insurer may decline coverage on the basis of the applicant’s personal habits, health, medical history, age, income or any other factors that bear on risk acceptance. Or the insurer may issue a policy with limitations on coverage. Most group insurance, however, is issued without medical examination or other evidence of individual insurability because the insurer knows that it can cover enough individuals to balance those in poor health against those in good health. The risk of an insurer failing to achieve this balance is diminished as the size of the group increases, or as the insurer underwrites additional group policies and increases the total number of individuals covered. This is known as the “law of large numbers.”
What is a deductible?
It is a specific dollar amount that an individual must pay (or “satisfy”) before reimbursement for expenses begins. The higher the deductible, the lower the cost of the health insurance plan.
What is a PPO?
A preferred provider organization (PPO) is an association that contracts with a group of doctors, dentists, hospitals or other health care service providers to provide care at prearranged rates or discounts.