What to look for when shopping for individual health insurance

Health Insurance

If you’re frustrated with the amount of money being deducted by your employer from your paycheck each month for health insurance, you may have considered going out on your own and buying your own individual health insurance at one point or another. Or perhaps your employer has hit upon hard times and decided that they can no longer provide you with health insurance. In either case, you might want to crunch some numbers and see if buying your own health coverage is a smart, money saving option.

Doing Your Homework

Some people may not even realize how good they have it until they leave their job and try to buy their own insurance. In most cases, they can’t afford to purchase comparable coverage on their own. That’s because large businesses and corporations benefit from buying in bulk and try to pass that benefit on to their employees. That’s why they call it a benefit. Employers are trying to use their benefit package to attract and keep good employees.

There’s also no guarantee that you will be accepted for an individual policy. Individual plans are more restrictive and pre-existing conditions may exclude you from consideration of coverage by some individual health insurance companies. Do your homework, though. Some states have “guaranteed issue” laws that require health insurers to offer you a policy regardless of which medical problems or background you have. Check your local laws and regulations before you decide to make the jump. Individual insurance providers may also increase your rates over time as you age, so take that into consideration as well.

Think Price

Price is probably the main reason you want to shop around for your own coverage, so you should know ahead of time that you can shop for bargains on premiums, which can sometimes vary by as much as 50 percent for the same person with the same health background and age, depending on which company you are getting a quote from.

Don’t fall into the belief that you’re healthy and can save all of your money by foregoing coverage completely, either. All it takes is a one serious accident to put you into “medical bankruptcy.” You can also lose your rights to coverage of pre-existing conditions if you go without insurance for 63 days or more, a time period set by the Health Insurance Portability and Accountability Act (HIPAA).

Here’s a list of questions to ask when shopping for individual health insurance:

  1. Do you want to keep your doctor? – Finding a good doctor whom you enjoy working with is important. That’s why you want to make sure that you can keep your doctor when you switch from your employer provided plan to your own individual provider.
  2. What are your anticipated health care needs? – Think of the services you use regularly. Do you need optical, dental, chiropractic? Do you or members of your family need some type of special, regular care for a particular health condition? Will you be covering your children or a dependant parent? Will your needs increase over the next few years, in turn increasing your premiums or costs?
  3. What can you afford? – You’ll need to figure out two different average yearly costs for your healthcare. One is the premium, and the other is your out of pocket costs. Each one can affect the other. A higher premium may lower your out of pocket expenses and vice versa. You’ll need to figure out what will fit within your budget. You’ll also need to figure out if the amount you’ll pay will end up being less than the amount your employer is currently deducting from your paycheck.

It’s incredibly important to find out all of the specifics for any health insurance plan you’re looking at. Here are some key areas to look at:

  • See if the plan covers prescriptions and x-rays. Prescriptions are the most often used part of a health plan. X-rays are routine parts of many treatments and can become expensive if not covered.
  • Make sure specialists are covered if you use them. This includes alternative medicine such as acupuncture or other specialties such as chiropractors and psychotherapists.
  • Find a comprehensive plan that covers more even if the deductible is higher. You might be able to find a cheaper plan than your employer offers, but don’t sacrifice key coverage such as hospital stays, which can get pricey.
  • Ask what the costs are for emergency care. This includes co-pays and deductibles. Also be sure to read the fine print on what your provider defines as “emergency care” as these definitions can and do vary from one provider to another.

This is by no means an exhaustive list of considerations to look at or questions to ask. Do your own homework and research all of your options carefully. Make sure that any “deal” you are offered is really worth gambling your family’s health on. If you are a careful shopper, you might be able to put a little extra money in your pocket each month.

For more information on individual health insurance please visit Premier Insurance Services of Chicago for a free Chicago health insurance quote.


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