HEALTH INSURANCE FOR INDIVIDUALS

There was a time when health insurance offered through one’s employment was the only feasible option. You’ve probably heard someone say, “I only keep this job for the insurance.” 

Luckily, private insurance is more attainable than ever, and in many cases- even more appealing than what someone’s employer may offer. This is largely due to the fact that employer-sponsored coverage is usually structured as a ‘pick #1, #2 or #2’ scenario, resulting in a package deal that may up the cost for certain benefits you don’t need, while lacking in other areas. Especially for a relatively-healthy individual, customizing coverage to fit your needs is the way to go!

If you’ve recently lost or changed jobs, you might be facing the decision of whether or not to elect for COBRA insurance. In almost ALL cases, this will be the most expensive option. Let us put together a plan that’s affordable and covers what you need. 

Some people are intimidated by number of options available when selecting private coverage. We specialize in making sure you aren’t overwhelmed, by helping to educate and steer you towards a plan that’s right for your circumstances. 

In the meantime, here is a summary of the main types of plans out there, and some other factors to consider:

Types of plans:

Health Maintenance Organization (HMO): These plans generally require you to choose a primary care physician (PCP) and get referrals from them to see specialists. They typically have lower out-of-pocket costs but offer less flexibility in choosing healthcare providers.

Preferred Provider Organization (PPO): PPO plans allow you to see both in-network and out-of-network providers without a referral, offering more flexibility but often at a higher cost.

Exclusive Provider Organization (EPO): EPO plans are a mix between HMOs and PPOs. They generally require you to use network providers but without needing referrals.

Point of Service (POS): POS plans combine features of HMOs and PPOs. They require a primary care doctor and referrals to see specialists, but you can also see out-of-network providers, usually at a higher cost.

Your Health Status:

Pre-existing Conditions: Private health insurers may consider your medical history when determining coverage and premiums. However, regulations may limit how they can exclude coverage for pre-existing conditions, especially in some regions with consumer protection laws. The most important thing is that you’re honest with your medical history when shopping for insurance, as most things are visible to carriers anyway and you want to make sure you get the coverage that’s right for you.