Being uninsured is very risky but many Americans who do not have insurance offered by their employer do not know that they can purchase health insurance for themselves, their spouse, and their dependents. Start by getting a free no obligation quote from several companies and then choose the one that best fits your needs.
What is individual health insurance? If your employer does not offer health insurance in a group plan or you are self employeed or unemployeed, you can purchase Individual health insurance independently. It can be sold to a single individual, to a parent and dependent children, or to a family. We can assist you with getting a quote, comparing plans, and the enrollment process. Get Started Now with a free no obligation Quote.
How is individual insurance different from group insurance? Group health insurance is offered through an employer and Individual Health Insurance is purchsed independently. Not all standard benefits in a group policy, like maternity coverage or substance-abuse treatment, are included in an individual plan. Sometimes individual health insurance consumers have the option to pay extra for coverage of additional services like maternity coverage. This extra coverage is referred to as an optional rider.
Cost is often the primary factor for individual health insurance consumers, which is another reason why the benefits included in individual policies are often simpler. In addition, deductibles (the amount you have to pay before insurance benefits begin) and cost-sharing (the fees you pay directly to medical providers at the time of service) are also generally higher.
How are premium rates determined? In the vast majority of states, when you apply for individual health insurance coverage, you are asked to provide health information about yourself and any family members to be covered. When determining rates, insurance companies use the medical information on these applications. Sometimes they will request additional information from an applicant’s physician or ask the applicants for clarification.
If the insurance company is unable to obtain information necessary to accurately determine the risk of a particular applicant, it will underwrite more conservatively, meaning that the assumption relative to the missing information will be negative rather than positive.
Once the company has determined your health status, you will be assigned a rate class by the company and put into a pool of other insured individuals with similar health status. Your premium will be the rate charged to that entire class of customers. Subsequent annual renewal premium rates will be determined not by your individual claims, but instead by the claims experience of the entire rating class pool.
Are any pre-existing medical conditions covered? Even though in almost every state an individual insurance company can choose not to offer coverage to people with serious medical conditions, most Americans don’t have perfect medical histories and most still qualify for individual coverage. However, there are some individuals who do not decide to purchase health insurance coverage until they know that they have a medical problem that will require the use of benefits. This is known as “adverse selection,” and it can be a serious problem for individual market insurance companies since their ability to spread risk is so limited.
To help prevent adverse selection, insurance companies are allowed to look back at your medical history for pre-existing conditions and may choose not to cover certain conditions for a specified period of time. This is known as an exclusionary, or pre-existing condition, waiting period. The amount of time an insurance company can look back at your medical history, and the length of time an exclusionary period can last, vary on a state-by-state basis.
In some states, you can receive credit against a pre-existing condition waiting period if you have had prior health insurance coverage within a specified number of days. The amount of the credit against the waiting period is generally proportional to the length of the prior coverage.
Can I still buy individual insurance if I have a very serious pre-existing medical condition? In most states you can be turned down for individual coverage if you have a very serious medical condition (e.g., HIV or cancer). Fortunately, even though they are not required to do so, most states have developed some way to provide uninsurable people with access to individual health insurance coverage.
For more information, go to www.nahu.org, The National Association of Health Underwriters where the preceeding information was gathered.
