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Individual Health Insurance Products
Are you self employed or do you work for an employer that doesn’t offer health insurance? Then you need an individual health insurance plan.
What is Individual Health Insurance?
Individual health insurance is the solution if you need to buy a health insurance plan outside of what your employer might provide.
For instance, if you are a contract worker, self-employed, or otherwise not eligible for a group plan, then you need to look into getting individual health insurance.
Depending on your state, you might only be able to do this during open enrollment periods in December and January (or immediately after you lose a job).
If you’ve experienced a major life change like unemployment or retirement, you also might be able to buy individual health insurance outside of the open enrollment period.
Why Do You Need Individual Health Insurance?
Health care coverage is essential and you might even risk a tax penalty if you don’t have some kind of health insurance or health care coverage in the U.S.
Remember that with individual health insurance, companies can’t turn you down or charge more because you have a pre-existing condition.
With individual health insurance plans, you can and will qualify for a plan.
Moreover, health care plans have to offer ten essential benefits according to the Affordable Care Act, which includes prenatal and maternity care, coverage of hospitalization, and preventative care.
Individual insurance plans also cannot cap the cost of the care that you receive in a given year or over a lifetime.
Keep in mind that you may also qualify for tax credits or subsidies that lower your out of pocket health care costs, also based on your income.
How Do You Choose the Right Type of Individual Health Insurance?
Individual health insurance plans vary by location and by insurance status.
In Illinois and other states, your insurance agent can help you pick out the best available plan for your needs.
Short term health insurance plans may also be an option if you are between jobs and need some coverage before your employer picks it up again.
You may have the option to purchase an individual health insurance plan directly from the company of your choice, or to buy on your state’s exchange.
What Type(s) of Individual Health Insurance Do You Need?
The amount of health care coverage or health insurance that you need depends on a variety of factors.
If your employer offers group health insurance you may be totally covered, but if you are self-employed or a contractor, you may need to get your own individual health insurance plan.
Before you purchase an individual health insurance plan or any other type of insurance plan, you should assess your personal health care needs.
How often do you see a doctor or doctors?
Do you need care from any particular specialists?
Do you prefer to go a specific practitioner or even a specific hospital or clinic?
Do you take any prescription drugs?
Overall, what types of healthcare do you require to maintain an acceptable standard of living?
You also want to keep in mind that you’ll most likely have co-pays and deductibles, depending on the type of individual health insurance that you purchase.
You should be able to get an idea of what these costs will be before you sign on the dotted line and buy a policy – an ASCO Insurance agent can help you – so you can determine what to budget for going forward once you’ve got your individual health care plan.
Keep in mind that inexpensive health insurance is not always good health insurance.
Your insurance agent can help you find the best deal on health insurance plans in illinois and beyond.
And while the exchange is useful and can help you understand your options, you should also be aware that there are a variety of individual insurers who offer their own plans which might be a better deal than the plans available on the exchange.
What is the Difference Between Various Types of Individual Health Insurance Plans?
When you buy an individual health insurance plan, you have the choice between an HMO (health maintenance organization), a PPO (preferred provider organization), or a POS (point of service) health insurance plan.
You can also get a high deductible health plan with an associated HSA or dedicated health savings account.
With an HMO, you can select a primary care doctor who’s responsible for coordinating your care including referring you to other specialists as necessary, and you’ll pay a copay for each visit.
You’ll likely be limited to a specific network of doctors and hospitals, and an individual HMO health insurance plan probably won’t cover care that’s outside of the network except in specific circumstances or emergencies.
The difference between a PPO and an HMO individual health care plan is flexibility.
These types of plans allow you to see specialists without a referral from your designated primary care doctor.
You will pay more to see physicians who are outside of your network, but you will have some coverage.
Doctors inside your network will have a low co-pay.
A POS health insurance plan is a combination of HMO and PPO in regard to costs.
If you stay in the network, it’s similar to an HMO, but you do have the option of going outside the network if you get a referral.
Finally, there is the option of purchasing a high deductible health plan and pairing that with a health savings account or HSA, which can help you cover that high deductible.
Any contributions you make to your HSA account are tax deductible, and any unused money rolls over to the next calendar year, plus you get to keep the account even if you change health plans.
Before you pick an individual health care plan, you should analyze the numbers and compare network providers and benefits – or work with an insurance agent who can help you figure things out.
What Other Types of Insurance Are Related to Individual Health Insurance?
Group health insurance, disability insurance, and other plans are all connected to individual health insurance and you may often be able to purchase these through the same insurance company.
Speak to an ASCO Insurance specialist today to learn more about individual health insurance.