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Health Insurance Individual Plans - How to Choose Individual Health Insurance Plans - Where to Buy Individual Health Insurance Plans, Employer Health Insurance

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By the time most people in the United States reach adulthood, they have come to discover the value of insurance. Without some form of insurance, even routine doctor visits could compromise the financial stability of the majority of Americans. A hospital stay could mean losing your home, car, or create a need to declare bankruptcy.

Where to Buy Individual Health Insurance Plans

Several factors will determine where and how you can buy an individual health insurance plan. Some of these factors include employment, age, income, and current health condition. Depending on these factors, an individual may be able to purchase a health insurance policy through one of three possible entities: an employer, the government, or private insurance companies.

Employer Health Insurance

Many companies in the U.S. offer a group health insurance plan for its employees. The cost of job-based health insurance depends on each particular company. Large companies and many government employees receive free health insurance as part of their benefits package. Other companies only make a partial payment on the total premium and the employee pays a share on a monthly basis.

Private Health Insurance

Private health insurance is bought either directly through an insurance provider or through an insurance agent. To receive private insurance, you must first qualify. Very few health insurance companies will sell a policy to an individual who suffers from an existing medical condition that requires a doctor’s care. The companies that will sell a policy to those with pre-existing conditions set several limitations and conditions on the policy. Some of these conditions include extremely high premiums and signing a release that the insurance policy will not cover any treatment stemming from stated conditions.

Government Health Insurance

Government health insurance is provided to individuals who are over the age of 65, children in low-income families, and the disabled. These individuals may qualify for one of two plans: Medicaid or Medicare.

Factors in Choosing Individual Health Insurance Plans

Employees of companies that provide health insurance and those who qualify for individual health insurance plans will based with several options from which to choose. The options will vary slightly between each type. Those who qualify for a government plan may have some choices in prescription drug plans or HMO care, but it is vastly different from regular insurance plans.

Individual Health Plans from an Employer

When hired on to a company, and sometimes after completing a minimum employment term from 3 to 12 months, several insurance plan options will be presented. Many of these plans will be what are called managed care plans. These plans will make you choose a particular health maintenance organization (HMO) or preferred provider organization (PPO). Some of these plans will limit you to care only within the HMO or PPO while others will allow limited care or additional copayments outside the network.

Choices in plans will include choosing levels of copayments and deductibles. Copayments are payments made out-of-pocket when services are provided. The insurance pays a portion of the total cost and your copayment completes the total cost. Deductibles are usually for hospital stays, but can sometimes apply to an aggregate of all medical services required in a particular time period. In the case of hospital stays, the deductible is the amount you pay out-of-pocket, per service or per stay, before the insurance kicks in to cover the expenses above that amount. The choice you make on how high the copayments and deductibles are will affect the monthly premiums that must be paid.

Individual Health Plans from a Private Company

For those who are self-employed, unemployed, and some early retirees, a private individual health insurance policy is usually the only option. In addition, a growing number of employers either do not provide insurance benefits for part-time employees or for any employees at all. Because so many people are not covered by insurance from their employers, insurance companies have been forced to provide a greater number of options to include people representing a larger income range.

Private individual health insurance plans can be purchased in one of three ways: directly through the provider, through a licensed agent, or online. So many options are now available to those who qualify that the choice can be quite confusing. This is the reason many people choose to work with an agent who can explain the plans in plain language. Some of the factors to consider include the following:

• Monthly premiums
• Deductibles
• Copayments
• Networks available and coverage outside the network
• Limits in the dollar-amounts covered
• Limits in services covered
• Coverage for pre-existing conditions
• Prescription drug benefits
• Inclusion of a health savings account (HSA)

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