Most Americans who have health insurance are covered through an employer’s plan. However, some employers do not offer health insurance coverage. If you work for one of these companies, you will need to purchase private individual health insurance.
There are certain advantages to purchasing health coverage in the private market. Instead of choosing from plans pre-selected by an employer, you decide which plan features you want, and pick a plan accordingly. For example, by choosing a plan with a higher deductible, or one that doesn’t cover certain services, you may realize a substantial premium savings each month.
Instead of having your coverage tied to a place of employment, coverage through a private health plan is yours to keep no matter where you work. A health insurer can’t drop you as long as you pay your premiums on time.
But along with these advantages come some potential disadvantages-
• Employer plans provide considerably more coverage than individual plans, even when you are paying the same premium rate. That’s because with an individual policy, a larger percentage of the premium goes to pay for such operational costs as marketing and paying claims.
• A group plan generally must insure all employees and family members, while individual plans can reject applicants who aren’t in perfect health. They can also offer plans that exclude coverage for certain pre-existing conditions.
• In most states, private health insurance plan premiums increase as you age. Initially, you can avoid these rate increases by periodically changing plans, because new rates tend to be lower than renewals. However, as you get older, it will become more difficult to find a company to insure you and individual policies will get more expensive.
If you do need to shop in the private health insurance market, you first need to find a competent insurance agent. Determining what kind of insurance you need and how much coverage to buy are complex issues. A good agent will help you assess your situation, and work with you to find the right coverage for your specific needs. The key to a successful working relationship with an insurance agent is trust. You should be able to trust your agent’s knowledge, experience and professional judgment, and you should always feel secure that your agent is acting in your best interest. But keep in mind that trust is a two-way street: Your agent also needs to trust you to provide information that is truthful and complete.
If you are comparing several plans, you need to know what to look for before making a decision. When choosing a health plan ask your health insurance agent the following questions:
8 Questions to Ask
- Will the plan cover me for the specific doctor or hospital I would like to use?
- How does the referral system work?
- What pre-existing conditions would affect coverage?
- How will the plan handle care if I (or a family member) am away from home?
- What is the plan’s monthly premium, and what deductible and coinsurance
amI required to pay?
- Are there other fees, such as copayments and any additional charges if I use providers that are out-of-network?
- Is there a maximum amount the plan will pay over a year or a lifetime?
- What types of benefits are specific to this plan?
The purchase of individual health insurance in the private market can seem confusing. Approach its purchase like you would that of any important item-research your options and compare prices, and get the best advice and assistance you can, in this case, the services of Brian Gruss a qualified insurance agent. (509) 927-9200