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Individual Health Insurance Coverage

Not everyone is lucky enough to be covered under a group health insurance plan that is paid for by his or her employer.  For peace of mind, it is important to have health insurance, but individual health insurance coverage is often unfamiliar territory for many people who are used to having their employer take care of choosing their health benefits provider.

If you are in the market for individual health insurance coverage, make sure you shop around, compare companies, and get the best price and policy for your needs.

Read on for more information about finding affordable individual health insurance coverage. When you are finished enter your information into our free quote finder and compare individual health insurance coverage options from competing insurance companies online.

What You Need To Know About Individual Health Insurance Coverage

When it comes to health insurance, ideally most people would like to be covered under a group plan where their employer foots the bill.  Group insurance plans guarantee coverage with no questions asked.  Unfortunately this same benefit does not exist when shopping for individual health insurance.

The upside is that individual health insurance coverage is much cheaper than group coverage. While not everyone is approved for individual coverage (approximately 80% of people are approved for a regular individual health insurance plan and approximately 90% of people are approved for a short term individual health insurance plan) if you are relatively healthy then you should have no problem obtaining individual health insurance coverage.

When comparing individual policies they will differ not only between companies, but by state and what you are looking for.   Often they can be complicated to understand, spelling out many limitations and exclusions.  Individual health insurance is not something you are going to be able to purchase overnight with minimal research.  You need to take time to gather enough information and quotes to make the best decision. 

Steps To Purchasing Individual Health Insurance Coverage

  1. You will have to provide evidence of insurability.  This often includes filling out a health questionnaire and in rare cases undergoing a medical examination (typically paid for by the insurance company) to make sure that your policy isn’t going to cost them an excessive amount of money each year.

  2. Before granting an individual health insurance policy, many health insurance companies will go back as far as ten years to determine if you have any pre-existing conditions that would disqualify you for individual health insurance.  This does not include short term diseases like a cold or flu.

  3. You may be denied coverage due to your personal habits, your age, health, medical history, or other “high risk” factors.  Those who regularly smoke and/or drink often times have higher premiums.

  4. If you have “high risk” factors you will not necessarily be denied individual health insurance.  The health insurance company may instead offer you a policy with limitations or higher premiums.

  5. If you have major risk factors and have maintained continuous health insurance coverage then depending upon your eligibility you may be offered coverage in a guaranteed issue HIPAA health insurance plan.

Types Of Individual Health Insurance Coverage

  1. Alternative Plans - If you can not find traditional individual health insurance, depending on your income and other factors you may be eligible for government Medicare, Medicaid, State Risk Pool coverage, or an above mentioned HIPAA plan.

  2. Service Based Plans - These include plans offered from Blue Cross Blue Shield and others.

  3. HMO (Health Maintenance Organization) - This is a pre-paid plan where a fixed monthly fee is paid for medical services instead of per visit.

  4. PPO (Preferred Provider Organization) - You receive a discount on medical services by going to pre-selected doctors.

  5. POS (Point Of Service) -  This type of plan is a hybrid that mixes components of an HMO and a PPO.

What To Look For In A Company Offering Individual Health Insurance Coverage

  1. Financial Strength - You want a large, stable company that has been in business for some time.  If you haven’t heard of them, your doctor probably hasn’t either and doesn’t participate in their plan.  The ones you want are those companies that have the financial strength to pay your claims in a timely manner without any hassle.

  2. Good Customer Service - Are the employees easy to work with?  Do you have to sit on hold for 45 minutes before you are helped?  For instance, phone wait time to talk to a representative is one of the biggest complaints from both doctor’s offices and patients about Champus/Tri-Care insurance provided to military and government workers.

  3. Comprehensive Coverage - You don’t want annual caps or limits placed on your policy, so look for comprehensive policies.

Ways To Lower Your Individual Health Insurance Coverage Premiums

  • Health Savings Accounts (HSAs).  These allow you to use before-tax money in a special savings account to pay medical claims until your deductible is met.  Depending on your health savings account, you can often use those funds to pay for co-pays and some over-the-counter medications and bandages as well as glasses/contacts, hearing aids, and dental coverage.

  • Co-pay plans vs. high deductible plans.  Co-pays are immediate benefits for your doctor and/or pharmacy that are not subject to your deductible.  High deductible plans offer the same comprehensive coverage as co-pay plans.  After you consider the savings that can be had by staying in network if you go with a PPO, a high deductible plan may be cheaper in the long run.

  • Look for family rather than per person deductibles as well as annual rather than per incident deductibles.  One insurance company may offer a $2,000 per person deductible while another offers a $2,000 per family deductible.  This can make a huge difference especially if you have more than two children.

  • Look into supplemental health insurance.  These are designed to be used in conjunction with a high deductible plan along with your HSA and they are sometimes more cost effective than buying a low deductible health insurance plan.  Sometimes the supplemental insurance will cover things that your primary insurance will not.

  • If you have a serious pre-existing condition, do NOT cancel your health insurance policy until you have found other coverage.  Many health insurance companies consider any condition that has been treated in the last ten years as pre-existing and can deny you coverage or charge higher premiums because of them.  There can be a lengthy amount of time that you have to wait before your new health insurance company will cover you.  Most likely that will cause much larger out-of-pocket costs than paying a high premium to keep your current policy. 

  • Re-evaluate your health insurance coverage annually.  Your medical needs will change over time and you want to make sure you are paying for the coverage you need and not coverage that is unnecessary.

Companies Offering Individual Health Insurance Coverage

The availability of individual health insurance coverage differs by state but here is a list of some of the insurers that are well known nationwide for offering affordable coverage for individuals, families, and the self employed:

Advantage Health Solutions
Blue Cross Blue Shield
Golden Rule
Kaiser Permanente
United Healthcare

Compare Individual Health Insurance Coverage Now!

Use our free tool at the top of the page to get started comparing individual insurance health insurance coverage from top insurance companies side by side.  Get started finding individual health insurance coverage now!