Individual Health Insurance

Affordable individual health insurance plans.

Individual health insurance plans are designed for people who do not have an employer-sponsored plan, or do not wish to enroll in the plan offered by their employers. In these situations, individuals can purchase a policy directly from an insurance company. Individual health insurance plans can often be more expensive and provide fewer benefits than those available through employers, which is why it is so important to compare plans closely.

When shopping for an individual health plan, make sure that you know the basic rules that apply in your state. In most states, for example, you may be turned down for health insurance coverage because of your health status. That said, you should be guaranteed renewal on your policy even if you become sick while you are covered. Pre-existing condition rules vary quite a bit from one state to another. In certain states, insurance companies can implement exclusion riders that will totally eliminate coverage for pre-existing conditions through the duration of your policy. Depending on your personal situation, this is a very important aspect to research for your particular state. You will also want to find out whether COBRA coverage applies only to employer-based policies.

The most common types of individual health insurance are Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans.

HMO’s are organizations of healthcare providers, doctors and hospitals, which have contracts with insurance companies to provide healthcare services at fixed rates. With an HMO plan, you will be required to select a primary care physician to handle all of your healthcare. If you already have a primary care physician who is not in the insurance company’s network, you will need to change to one who is in the network. Additionally, if you need to see a specialist, you will have to visit your primary care physician for a referral. Many HMO’s, however, offer an indemnity-type option known as a Point of Service (POS) plan. The primary care doctors in a POS plan usually make referrals to other providers in the plan. With a POS plan, members can refer themselves outside the plan and still get some coverage. If the doctor makes a referral out of the network, the plan pays all or most of the bill. If you refer yourself to a provider outside the network and the service is covered by the plan, you will have to pay coinsurance. While HMO plans have many rules and restrictions, they are relatively inexpensive.

PPO plans also have contractual relationships with insurance companies but are much more flexible in practice. You may select a primary care physician who is not in the insurance company’s network, but it will be more expensive. Unlike HMO plans, PPO plans do not require you to obtain a referral to visit a specialist. PPO plans are more expensive than HMO plans but are often desirable because you have more control over your healthcare decisions.

Keep in mind: while it may be more expensive to acquire health insurance as an individual, it is nowhere near as expensive as going without any health insurance coverage at all.