People shop for individual medical insurance for a number of reasons, including loss of employment, switching to self-employment, or the need for a better suited policy. Even though you expect it to be easy to shop for your own insurance, you may find yourself confused by what a plan covers.
All plans are required to cover ten essential benefits and provide coverage to all individuals regardless of pre-existing health conditions. These essential benefits include:
- Ambulatory patient services
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and rehabilitative services and devices
- Laboratory services
- Preventive and wellness services
- Pediatric services, including oral and vision care
What to Consider When You Shop for Insurance
When you're thinking about buying individual medical insurance, you should be familiar with when you can enroll in a health insurance plan, your medical needs, and what kind of health insurance you'll need.
First, familiarize yourself with the enrollment dates for 2019 coverage. This year, the Open Enrollment Period is expected to go from November 1, 2018, to December 15, 2018, in most states.
During this time, you are also eligible to change current plans or apply for cost assistance, unless you qualify for a special enrollment period.
Second, before beginning your search, you need to determine the kind of coverage you need from your health insurance. Do you visit the doctor regularly or only when you're sick? Do you have any existing medical problems you'll need coverage for? What plans do your local hospitals and doctors take?
Finally, see what type of individual medical insurance is right for you. There are five health plan categories that determine how much your premium is versus how much you'll be paying out of pocket:
- Bronze: Insurance pays about 60 percent. You pay about 40 percent.
- Silver: Insurance pays about 70 percent. You pay about 30 percent.
- Gold: Insurance pays about 80 percent. You pay about 20 percent.
- Platinum: Insurance pays about 90 percent. You pay about 10 percent.
- Catastrophic: These plans pay less than 60 percent of the total average cost of care. They're only available to people under 30 years old or have a hardship exemption
As you can tell, there's a lot that needs to be considered when finding the right medical insurance coverage for your needs. So let us help you find one.
HealthMarkets can make it easy to find the right individual health insurance coverage you need. We can help you find the right category of health insurance that best fits your health needs and matches your budget and lifestyle.