Health insurance can protect you from financial disaster if you get sick. Most Americans get their health insurance through their employer. However, if you are self-employed or if your employer does not provide insurance, you might have to buy individual health insurance. It is important to understand what various kinds of coverage provide.
Significance
Individual insurance plans are a viable option for the 14 percent of Americans who are either self-employed or do not have access to health coverage through their jobs. You can choose to go without insurance, but then you are personally responsible for your health care costs, which can be substantial. If you have relatively no assets, you might be covered under a government program.
Considerations
Individual health insurance usually is more expensive than group coverage because the risk of illness or injury is not spread out over a large number of people. It also can be difficult to qualify for individual coverage if you have any types of health problems. However, health insurance reform is working toward making insurance coverage more accessible even if you have a preexisting condition. If you cannot get private coverage, some states offer high-risk pools that cover individuals who have been denied. Check Resources for a list of the states that offer plans.
Coverage Options
You can buy coverage to help pay for physician and other health care provider services, hospitalization, Emergency Department visits, physical therapy, behavioral health services, dental and vision services and medications. Depending on your health history and your budget, you can get an individual policy that covers just about any service that is available in employer-provided coverage. As with employer coverage, you can individual fee-for-service plans or HMO or PPO coverage. If you are considering an HMO or PPO, review the list of health care providers the plan includes, especially if you want to remain under the care of a specific provider. You can also buy a very high-deductible policy and set up a tax-advantaged health savings account to help pay the deductible and other out-of-pocket costs.
Maternity Coverage
With an individual health insurance policy, it is important to consider your lifestyle, age and health care needs. Buy only the coverage you and your family need. If you are planning on having children, be sure to purchase a plan that covers maternity services. Read the benefit offerings carefully, because some plans that do offer maternity coverage also have a waiting period before you can access those benefits.
Supplemental Plans
Another option for individuals is what is known as supplemental plan coverage. Supplemental plans do not offer medical coverage; they offer specialty products such as cancer coverage, products that will pay you if you are hospitalized, special accident policies, disability following illness or injury, dental coverage and a host of other options. Some plans help you pay out-of-pocket expenses for specific health problems or provide a lump sum payment. Supplemental coverage usually works best as an addition to your regular health care coverage.
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