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Individual Health Insurance 101


Everyone knows that health insurance is a very important thing to have. However, some people don’t know that there are alternatives to group health insurance. While group health insurance usually costs less and offers more benefits, some people cannot get it. People who are self-employed or work for a small company have the option to choose individual health insurance. Individual health insurance is exactly what it sounds like; an individual buys health insurance for himself or herself.

It can sometimes be difficult to get individual health insurance (especially if you are over 50 years old). Many insurance companies may require you to take a medical exam to determine if you are insurable. For this reason it is important to look at many different insurance companies. Unfortunately, you may run into some companies that simply think you are too great of a risk. However, it is also a good idea to shop around for insurance policies because different companies give different benefits at different prices. You will be paying for the policy on your own, and so it is important to get the best deal for you and your family. A few things to consider when looking for a company are the amount and types of payments you will have to make, the amount of coverage you will receive, what exactly the plan covers, and if there are any limits to the plan.

There are a number of options available for individual health insurance. The options include fee-for-service insurance, managed care plans, open enrollment in managed care plans, association-based health insurance, and high-risk pools. Fee-for-service insurance, which can also be called indemnity insurance, is a more traditional type of insurance. The insurance company will pay for part of the cost of hospital stays and doctor visits, while the policyholder pays for the rest. This type generally costs more than other insurance types, but allows the policyholder to go to whatever doctor he or she desires.

Managed care plans, such as an HMO or a PPO, are very popular. Health insurance companies contract with select doctors and hospitals in these types of insurance plans. Therefore, policyholders are limited to a select group of doctors and hospitals. Some plans, like PPOs, may allow the policyholder to visit doctors outside of the network, but it will cost more. People with this insurance policy generally pay a very small co-payment at a doctor visit. Some states have requirements in place that force managed care plans to have an “open enrollment” period each year. The timeframe is usually a month, and managed care plans are required to let anyone join the plan even if they have a serious medical condition.

Association-based health insurance is acquired through a trade or professional association. If you belong to a professional, community, or religious organization, you may be eligible for their insurance policy. Naturally, you should learn more about your group’s insurance policy before signing up.

High-risk pools can be sources of insurance for people who have not been able to get other types of insurance because of a serious medical condition. This type of insurance is seen as a last resort, and the policies regarding it vary from state to state.

Although individual insurance plans cost more than group insurance plans, it is still very important to be covered. Researching different companies and deciding which type of plan is right for you can help. Today, many people need hospital treatment, and those without insurance face many difficulties. Even though it may cost a bit, in the end, if you have a serious medical problem, you will be happy that you signed up for insurance.


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