An individual health insurance plan may be defined as a complete medical insurance plan that offers personal health as well as medical coverage to you, when you fell sick or are injured, and sometime to your family too. In other words, we can say that it is an individual health insurance policy bought directly by you from an insurance company. Such insurance policy does not serve as a part of a group insurance plan.
1) Getting an individual health insurance is not an easy task. When you will buy a health insurance plan as an individual, you will have to pay higher than what you pay for a group insurance plan. However, being a self-employed or an employee of an employer that does not provide the facility of group health insurance, you have no other option to get medical coverage other than buying an individual health insurance policy.
The situation becomes worse, if you are a cancer survivor and still getting treatment for your medical condition. In such a case, even if the health insurance company agrees to provide coverage to you, it will probably implement a waiting period for covering your cancer related treatment expenditures. Or, it will start providing coverage only after your treatment is over.
2) While you are planning to purchase an individual insurance plan, make sure that you are buying it from a reputed and reliable company. Also, ensure that it covers the need of your family. You can consult Department of Insurance in your respective state to get in-depth details about different health insurance companies serving in your state. Ask about some points like,
- Whether the insurance company is licensed in the state
- Whether there were any disciplinary actions taken against the insurance company for operating any unlawful business practice
- Whether the claimants have had any negative experience with the health insurance company
3) Get enough information about the individual health insurance plan and choose the right one that suits your individual need and budget. While applying for an individual plan through your state, the application form will undergo an underwriting procedure including your medical history and health records. According to the underwriting report, a health insurance company will decide whether it will provide you health coverage. Sometimes, the company may provide you coverage against higher premiums, if you have medical conditions like cancer. It can also implement a waiting period for pre-existing medical conditions.
4) There are two types of individual health insurance plans available; Indemnity Health Insurance plan and Managed Care Health Insurance plan.
- Indemnity Health Insurance Plan – Indemnity plan is also known as fee-for-service health plan. Indemnity plan lets the policyholder use any of the services provided by the plan, when required. The insurance company pays a certain percentage of the indemnity policyholder’s medical expenses. Indemnity plan allows the policyholder to select a doctor, hospital and other healthcare providers for his or her personal healthcare as per his choice.
- Managed Care Health Insurance Plan – Managed care plan generally uses a network of certain physicians to whom the plan members can visit for healthcare services, when needed. Managed care plans normally offer lower premiums than that of the indemnity plans. However, the options of physicians, hospitals, medications and services are restricted.