Group health insurance plans may offer more favorable rates and broader coverage, but these plans are not for everyone. A growing number of Americans have no choice but to purchase coverage through an employer-provided group plan. Others may have the option but choose to insure individually because of specific health care needs. Here is some helpful information about individual health insurance policies and how these could benefit your family:
Why Buy an Individual Health Insurance Policy?
Some people choose an individual health policy because the group coverage available to them is not sufficient for their family’s needs. In most cases, holders of individual health policies cannot acquire group coverage. That’s because their employer does not offer a group plan, they are unemployed or self-employed, or they are a college student. An individual health plan may be the only option for these people.
Health Insurance for Families—an Essential
Uninsured medical expenses are a leading cause of family bankruptcy in America. That’s why people without access to a group plan need individual health insurance for themselves and their families.
Also, some health and medical expenses are unpredictable—you never know when an illness or injury will strike.
Others are expected: childbirth, vision and dental care are just a few examples of the events and conditions for which health insurance coverage is essential.
Controlling Costs of Health Insurance
Apply these ways to keep the cost of your health insurance down:
- Ensure you are not eligible for a group plan. Group health plans are not exclusive to your employer. Your spouse’s employer or an organization that you are a member of, such as an alumni association, civic organization or even credit card company, may offer your family a group health insurance plan.
- Consider raising deductibles, co-payments and coinsurance. Deductibles and co-payments refer to the amount of money you must pay out-of-pocket before your insurance company pays. Coinsurance refers to a percentage of a claim for which you are responsible (i.e., for certain expenses you may be required to pay 20 percent and the insurance company pays the balance). The more expense you can afford to handle yourself the lower your premium. Never raise deductibles, co-payments and coinsurance to a level you cannot afford to pay.
- Review physicians and networks. Most health insurance plans include a network of care providers. These providers are considered “in network.” Your health insurance plan likely will limit the amount it will pay for visits and treatment to an “out-of-network” provider. If you have physicians you prefer, make sure they are included in the plan’s network before you purchase the coverage.
What to Expect from an Individual Health Plan
When you get access to a group health insurance plan through an employer, signing up is fairly easy. You know what kind of insurance coverage you’re going to get and it’s just a matter of understanding the plan itself. When you get a health plan for yourself, you have to make a lot of choices and understand what may or may not be covered in your new health insurance plan.
Age Affects Insurance Rates
While there are many things that can affect the insurance rates on a health plan, one primary factor is your age. The younger you are, the less your insurance premium will be, assuming you are in good health. This also means as you get older, the premium on your insurance will increase.
All Health Insurance Coverage Is Not Included
When you purchase a health insurance plan yourself, don’t expect it to cover dental and vision as well. You may be able to purchase insurance plans that include these at an additional cost, but most likely, you will have to buy separate dental insurance and vision insurance if you require coverage for those needs.
Read the Fine Print on the Insurance Policy
If you’re planning to have a family soon, make sure that the health insurance plan has maternity coverage. Not all plans offer it, and coverage will be much harder to get after the fact. The same goes for any pre-existing condition you may have. Read the fine print on any health insurance policy before you commit to it.
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