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Individual Health Insurance
Simply put, health insurance is protection against medical costs. A health insurance policy is a contract between an insurer and an individual or group, in which the insurer agrees to provide specified health insurance at an agreed-upon price (the premium). Depending on your policy, your premium may be payable either in a lump sum or in installments.
Health insurance usually provides either direct payment or reimbursement for expenses associated with illnesses and injuries. The cost and range of protection provided by your health insurance will depend on your insurance provider and the particular policy you purchase. If your employer does not offer a health insurance plan, you may wish to purchase health insurance on your own.
For an instant online health insurance quote for you or your family, please fill out our online form.
Know What to Look for When Buying Individual Health Insurance
Most Americans who have health insurance are covered through an employer's plan. However, if your employer does not offer health insurance coverage or if you are self-employed or not working, you will need to purchase your own individual health insurance.
There are certain advantages to purchasing health coverage in the individual market. Instead of choosing from plans pre-selected by an employer, you decide which plan features you want, and pick a plan accordingly. For example, by choosing a plan with a higher deductible, or one that doesn't cover certain services, you may realize a substantial premium savings each month. If you are healthy, you can be judged on the merits of your own health and not tied into a group, which tends to factor in the average health of a group when determining the cost.
Instead of having your coverage tied to a place of employment, coverage through a private health plan is yours to keep no matter where you work. A health insurer can't drop you as long as you pay your premiums on time. But along with these advantages come some potential disadvantages:
Employer plans may provide more coverage than individual plans. This is not always the case but you should know what you might be giving up.
A group plan generally must insure all employees and family members, while individual plans in Connecticut can offer the state's reinsurance pool for applicants who aren't in perfect health. They can also offer plans that exclude coverage for certain pre-existing conditions.
Some, but not all, individual plans offer different rates for their existing plan holders than they do for their new business. The only way to get around this imbalance is to move to a different plan when that happens, but that could mean having to re-qualify.
If you do need to shop in the individual health insurance market, you first need to find a competent insurance agent. Determining what kind of insurance you need and how much coverage to buy are complex issues. A good agent will help you assess your situation, and work with you to find the right coverage for your specific needs. The key to a successful working relationship with an insurance agent is trust. You should be able to trust your agent's knowledge, experience and professional judgment, and you should always feel secure that your agent is acting in your best interest. But keep in mind that trust is a two-way street: Your agent also needs to trust you to provide information that is truthful and complete.
If you are comparing several plans, you need to know what to look for before making a decision. When choosing a health plan ask your health insurance agent the following ten questions:
- Will the plan cover me for the specific doctor or hospital I would like to use?
- How does the referral system work?
- What pre-existing conditions would affect coverage?
- How will the plan handle care if I (or a family member) am away from home?
- What is the plan's monthly premium, and what deductible and coinsurance am I required to pay?
- How does the carrier handle rate renewals?
- Are there other fees, such as co-payments and any additional charges if I use providers that are out-of-network?
- Is there a maximum amount the plan will pay over a year or a lifetime?
- What types of benefit limits are specific to this plan?
- What types of expenses are excluded from coverage.
The purchase of individual health insurance in the private market can seem confusing. Approach its purchase like you would that of any important item ---research your options and compare prices, and get the best advice and assistance you can --in this case, the services of a qualified insurance agent.
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