In the United States, people tend to obtain health insurance through their employers. In a group insurance plan, as such an arrangement is called, participants enter without regard to their health status or preexisting conditions. Typically, the employer foots a large portion of the bill. But if you cannot obtain insurance through an employer, you may have to look for a private insurance plan. You will generally pay more for your coverage in this type of plan.
Basics
Private health insurance plans, also known as individual plans, involve underwriting, though the process varies from state to state. That means the amount of the monthly premium you pay depends on factors such as your age, weight and medical history, as well as whether you smoke. You may even have to submit to a medical exam as part of the process, according to Smart Money magazine. If the insurer thinks your risk of health problems is too high -- if you have a history of cancer or heart disease, for example -- you can be denied coverage, at least in some states, according to Smart Money. Even common conditions such as asthma, anxiety and depression can factor in.
Considerations
Premium cost is only one of many considerations when buying private health insurance, according to the Healthcare Survival Guide, a book by Martin Rosen and Dr. Abbie Leibowitz. Questions to ask the insurance company or broker include: what the plan does and does not cover; whether there are annual or lifetime limits for certain services; what the deductibles are; and what the co-payments are for physician visits, emergency room care and hospitalization.
Cost
PricewaterhouseCoopers, in an October 2009 report for America's Health Insurance Plans, wrote that the average cost of family coverage was $12,300 per year. Coverage for a single person was, on average, $4,600 per year. The report predicted growth in 2010 to $13,000 and $4,800 for family and single coverage, respectively.
Process
Because choosing health insurance is such an important decision, you will want to shop carefully. Web sites such as eHealthInsurance.com and Insure.com will give you a broad overview of the options available. If you feel overwhelmed, you can get in touch with an insurance broker in your area for help in finding a policy. It is important, according to Smart Money, to choose a broker who works with a large number of insurance companies, not just a few, and is highly familiar with the underwriting standards of each. Otherwise, you may end up applying to companies who are sure to reject you.
Expert Insight
If you think there is any chance you might get pregnant, add what is known as a maternity rider when you sign up for the plan, says Ellen Corwin, a broker of individual health insurance in West Des Moines, Iowa. "I advise all of my female clients to get one," she says. Individual plans, unlike employer group plans, do not cover maternity expenses unless such coverage is specified at the outset. And some individual plans make it difficult to add the coverage later. For example, Blue Cross Blue Shield of Tennessee, according to Smart Money, had as of 2008 a rule forbidding a woman to add the benefit subsequent to the initial purchase unless she submitted a "notification of change in status" and married.
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