The main type of health insurance purchased by persons that do not have access to a group health plan through an employer is an Individual Health Plan.
This type of coverage may include immediate family members. The insurance contract is between the “applicant” and the insurance carrier and
responsibility for payment of premium is solely on that individual applicant. Other commonly used names for this type of coverage include personal
health insurance, family health insurance and child’s health insurance.
Who Should Consider Individual Health Care Insurance
Any person or family that does not have access to group health insurance, or not eligible for state sponsored programs for lower income families, should
consider purchasing individual healthcare insurance. Everybody should have some form of health insurance, and this is the right option for permanent
coverage for a number of reasons. If you delay in acquiring a personal health plan, you may lose your opportunity for qualifying for coverage because
it is only available if you meet the guidelines imposed by state regulations and insurance carrier policies.
The Cost of Individual Health Insurance
Individual health insurance rates are determined by many factors, including chosen plan type, age, gender, geographical location and health status. Plan
types range from HMO plans to high-deductible catastrophic health plans. The more possible additional plan benefits, the greater the risk to the
insurance carrier in having to pay claims. Since rates are based on the risk to the insurance carrier, these plans with more complete coverage will be
the most expensive.
When shopping for an individual health plan, you will find a vast array of plan and premium options. Naturally, you will want to find the right coverage
for the most affordable price. The right thing to do is set a budget for your monthly health insurance costs and look for the right coverage that fits your needs for
that price.
Applying for Individual Health Insurance
Once you have found the right health plan for you and your family, you will need to submit an application for coverage. The application is fairly
complicated, with many health related questions. Not every person that applies for individual health insurance will be accepted by the insurance carrier
and not all insurance companies have the same acceptance guidelines. An experienced licensed health insurance agent can guide you in your eligibility and the
most recognized companies to apply with before you start the lengthy application process.
If you have had any current or recent health conditions that required medical treatment or medications, the insurance carrier may request review of your
medical records before they can make a decision in regards to your insurability. This process can take several weeks. If you are currently uninsured,
it would be advisable to purchase a temporary health plan while you are going through the application and underwriting process for an individual or
family health plan.
If you learn that you are not eligible for individual health care insurance due to your medical history, your next option is to obtain coverage through
an employer sponsored group health plan. If this option is not available to you, many states have high-risk pools available, but the monthly premiums
for these state sponsored programs can be rather expensive.
Several changes took place on September 23, 2010, that significantly benefit families seeking coverage under a family health insurance plan.
1. Children who may have been uninsurable due to a pre-existing condition can no longer be denied coverage.
2. Preventative screenings, such as annual physicals, mammograms, and pap smears are now provided to you and your family for free.
3. Your dependents can now stay on your family health insurance plan until the age of 26. This is significant because, prior to the change, a child
with diabetes who turned 19 and was not a full-time college student would have rolled off her parent’s health insurance. The child's only option for
health insurance would often be employer coverage.
What You Need To Know
First, unless you obtain a NEW family health plan, the benefits of health care reform will not apply to you and your family. The new rules do not apply
to “grandfathered” plans.
Second, many health insurance carriers are no longer offering child-only health insurance plans. This means that in order to receive coverage for your
child or children, you will need to add them to a family health insurance plan.
Third, with preventative screenings being offered for free with a new health plan, everyone should consider at least basic coverage in order to detect
early illness and potentially life-saving results.
What To Look For In A Family Health Insurance Plan
A good family health insurance plan covers the healthcare needs for you and your family today and well into the future. In fact, young families who
plan to have children will find that you can typically expand your health insurance to cover new additions to the family with little effort.
When it comes to family health insurance plans, most of us want to maximize the benefits that come with our plan while minimizing the cost of that plan.
This isn’t always easy. The first thing you should do is assess your family’s needs based on everyone’s age and health to determine what level of
benefits you need.
The larger your family, the more people are on your health plan, the more your plan is likely to cost. Other factors can impact the cost of a family
health plan as well, like maternity coverage, plan type, deductible and so on.
When comparing plans, make sure your preferred doctors, including pediatricians and OB/GYN, are part of the network for the plans you’re considering.
