Who Needs Individual Health Insurance?
Anyone who is not eligible for group health insurance coverage is a prime candidate for individual health insurance. Even some workers who can access a group plan sometimes consider individual health insurance if the group plan's coverage does not fit their needs.
An Important Consideration:
Most individual health insurance plans are more expensive and less comprehensive than group plans. For these reasons, you should consider all possible sources of group health insurance before purchasing an individual policy. Sources may include your spouse's group plan or a group plan offered through a membership organization, such as AARP, a civic association, an alumni group, a credit card provider or other group to which you are a member.
If you do not have access to a group health plan and want coverage, contact your insurance agent about options for an individual plan. Information about individual health insurance plans also can be acquired by contacting the insurance company directly or through its Web site.
What is Covered?
Individual health plans, much like group plans, may cover only certain types of procedures and medical expenses, including prescription drugs. Plans differ considerably based on several factors. These factors include:
- Who will the plan cover? Is the plan for only you or are there others (e.g., spouse and children) who need coverage? The age and medical history of those on the plan also may have a significant impact on price and coverages.
- Where you live, the type of care to which you have ready access, and whether your local health care providers accept that particular insurance company's coverage.
- Benefits needed or desired.
Individual Health Insurance Policy Tips
Here are several points to consider as you decide which individual health insurance plan is best for you and your family:
- Get the best fit. If you or a family member receives regular treatments or medicines, be sure to select a plan that will offer the most coverage for those. Consult your doctor and pharmacy for information about health insurance providers in your area.
- Look for flexibility. Some plans may cover services that are not as relevant to you as others. For example, you may not need regular prescription medication and are more interested in applying your premium to vision care coverage. A flexible plan can help you control costs.
- Do your research. Research the plan's benefit levels and health provider network. After reviewing the information about the plan benefits, be sure you understand exactly what your out-of-pocket expenses will be. Talk to the provider if necessary. In addition, be sure the plan's network offers health providers and services that are relevant to your needs and the physicians/providers you already use.
- Tax implications. Talk with your tax advisor about deductions for individual health insurance plans. If you are self-employed most of the premium is tax-deductible. There may be differences in deduction methods if the plan is purchased through a legal entity other than a sole proprietorship.
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