Jan 13 2008
Individual Health Insurance – The Basics
When an individual or family does not have access to major medical insurance through their employer or government program, they may choose to purchase an individual health insurance policy.
How it works:
Health insurance is important to have because it ensures access to health care and minimizes the financial loss that can result from treating a serious illness or accident. Insurance companies enable policyholders to share the costs of possible economic loss by pooling the risk of health care costs across a large number of people. Insureds pay premiums based on the average cost of medical care for a group of people and receive medical benefits and financial protection when health care costs arise. Each state sets its own requirements for individual health policies and regulates how they can be marketed and sold.
Types of Individual Major Medical Health Plans:
Basic Benefit Plans: Provide essential benefits (i.e., inpatient hospitalization and outpatient surgery coverage) at an economical price. These plans may be appropriate for people who primarily want protection against the event of a serious accident or illness.
Comprehensive Plans: Provide the widest array of benefits and flexible plan options. They typically cover a variety of medical services, so they tend to have the highest prices. These plans are appropriate for people who want a more extensive range of benefits.
HSA-Qualified High Deductible Health Plans: Offer coverage coupled with the option to open a Health Savings Account (HSA). These plans are a good option for people looking for more control over how their health care dollars are spent.
Short-term Plans: Provide temporary coverage for those in-between jobs or waiting for group coverage to begin. They are best for those who need coverage for a definite period of time (i.e. 3 months) before beginning coverage under a permanent policy.
Choosing the right plan:
You have several factors to consider while selecting the right health plan for you and your family. Here are some practical questions to answer (with help from your agent) when choosing the right health insurance plan:
- What insurance benefits do you anticipate using?
- How much do you want (or can you afford) to spend on health insurance premiums each month?
- How many times a year do you visit a family physician or specialist?
- Do you want to utilize options such as preventive care and supplemental accident?
- What is the most you can afford to pay out-of-pocket in the case of a serious accident or injury?
- Do you need coverage for the long-term or short-term?
Applying for Coverage:
Warren Financial can help you determine your health coverage needs, match you with the appropriate health plan, and guide you through the application process. We strive to find an affordable health insurance plan to fit your needs and your budget. Affordable health insurance is an extremely important aspect to protecting our health and financial standing.
Eligibility: Applicants must meet age, health, residency, and occupation/avocation requirements to be eligible for coverage.
Underwriting: This is the insurance company’s process of determining whether or not they will accept an insurance application for coverage. Individual health applications are underwritten based upon various criteria applicable to all individuals applying for coverage. All decisions are made on an individual basis and take into account the applicants entire medical profile. To effectively underwrite each application, an insurance company must obtain complete medical information on the applicant(s) through the use of health questions on the application and, as necessary, a combination of telephone verification and/or medical records.
Click here to begin your search for affordable health insurance.
