Contrary to popular belief, individual health insurance isn’t just for individuals. One of these plans can cover multiple people, such as a family. Individual policies are regulated by each state, while the Affordable Care Act (ACA) has made some federal-level changes to how these policies are rated, as well as the benefits that policyholders receive.
Individual Health vs. Group Health
Many ask the difference between individual health insurance and group health insurance. Simply put, group health insurance is offered by employers to employees or by associations to their members. This coverage can be full or partial, which may include the ability to select from a list of choices. An individual health plan is bought by individuals as opposed to through an employer or association, and can cover an individual as well as his or her family.
Types of Coverage
There are several items that you should look at before choosing your plan. It’s important to consider factors like your budget, your lifestyle and the inherent risks of it, and health issues you may face in the future. You should also consider the scope and types of network each plan is associated with, and how accessible care is for you within those networks.
For example, some plans have a higher monthly premium with lower deductibles and less cost at the delivery of healthcare, and other plans have lower premiums with higher deductibles and care costs. If you plan to have a baby, this should also be taken into consideration.
There are a few types of individual coverage, including:
- Health maintenance organization (HMO)
- Preferred provider organization (PPO)
- Exclusive provider organization (EPO)
- Point of service (POS)
When looking at individual insurance plans, consider elements like:
- Emergency services
- Ambulatory patient services
- Wellness and preventive services
- Prescription drugs
- Mental health
- Substance abuse services
- Lab services
- Newborn and maternity care
- Pediatric services
Hiring an Insurance Agent
It’s a good idea to consult an insurance agent before selecting an individual health insurance plan, especially with new complexities that have arisen from the Affordable Care Act. An insurance agent is familiar with all the industry jargon, and is equipped to help you choose exactly which plan is best for your needs, including whether you’re best suited for an individual health plan or a group health plan.
The team at Murray Insurance has decades of experience serving Central Florida for health insurance needs. Call us today for the best individual insurance plan for your needs.
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