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You might be searching for individual health quotes. Perhaps you have experienced some changes this year that have prompted this search. Before you begin examining health insurance for you or your family, be sure you know some key things first.

What is individual health insurance? The term can lead to some confusion. Simply put, individual health insurance is coverage purchased by an individual for themselves or their family.  It is different from group health insurance, which is purchased through an employer. Individual health insurance coverage can be applied to the immediate family. It is not just for one person, as some people mistake the “individual,” in individual health insurance, to mean.

There are several reasons why you might seek an individual health quote. You may be self-employed, unemployed, or simply unhappy with the coverage offered by your employer. You may fear that buying health insurance is an expensive endeavor. But going without coverage not only leads to a penalty, it can also have costly health consequences. 

Historically, individual health insurance has cost less than most group plans. This is partly because the risk was spread over a larger group of people (thousands of people versus a group of employees.) But also because the level of coverage has traditionally been less than what group plans offer. Changes in the law now require all plans to cover essential health benefits such as hospitalization, emergency services, laboratory testing, mental health and substance abuse, maternity care, prescription drugs, outpatient care, pediatric services, prescription drugs, and preventive and rehabilitative services. While inclusion of these services may have caused costs to increase, subsidies are available for persons meeting eligibility requirements. These tax credits can help defray expenses.

Given all plans are now required to cover these basic major services, only two major concerns remain; cost and which doctors/hospitals are in a plan. To make cost comparison easier, plans have been categorized into metal tiers.” Bronze plans cover about 60 percent of total healthcare costs. Silver covers about 70 percent, with gold and platinum plans covering close to 80 percent and 90 percent, respectively. That doesn’t mean understanding individual health quotes is easy. There are still varying combinations of premiums and cost-sharing. Because out-of-pocket costs are not standardized, understanding provisions can sometimes be difficult. 

Every health insurance plan has a network of providers. Asking which doctors or hospitals are included in a plan is essential. If you wish to continue services with a particular physician without fear of getting stuck with the bill, it’s best to know upfront what imaging centers, laboratories, pharmacies, and doctors are in a particular network.

Aside from these factors, you want to be sure you pay attention to enrollment periods. Enrolling in coverage outside of open enrollment, usually requires a qualifying event, such as marriage, divorce, or birth of a child.

Because of the diversity of plans (which can have very different deductibles, copays, and networks), it’s important to seek assistance when reviewing individual health quotes. Add the worries of possible penalties for being uninsured or underinsured, enrollment periods, and potential missed savings through subsidies, and an excellent case has been made for using professional help.

HealthMarkets Insurance Agency is changing the buying experience for health insurance products for individuals and families. We offer unmatched levels of service that helps you get the right amount of coverage at the best price. Best of all, our assistance is absolutely free. HealthMarkets operates independently of carriers and the government and offers non-biased advice on individual health insurance choices.  Give us a call today!


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