PLEASE NOTE! The Health Insurance Marketplace Open Enrollment period ended February 15th. If you do not have a qualifying life event, you are unable to purchase an Obamacare ACA insurance plan. With that said, Short Term Health Plans have become the primary product in the market, providing insurance coverage until the next open enrollment period. Please consider purchasing a Short Term Health Plan until the next Open Enrollment period. Open Enrollment for 2016 coverage starts November 1, 2015.
Individual health insurance is simply healthcare insurance coverage that you purchase for yourself or your family (as opposed to health insurance provided by an employer). Whether you are self-employed, between jobs or work for a company that does not offer a plan that meets you or your family’s needs, individual health insurance plans enable you to make sure you and your loved ones are covered for those unforeseen medical expenses.
There are a variety of plans available that will help you meet your specific financial and benefit level requirements. Contact us today to get expert advice about which individual health insurance option is best for you or your family members, or compare low cost Individual health insurance quotes online using our quote engine.
What Types of Individual Plans are Available?
There are a number of affordable individual health insurance plans to meet your specific health care needs. The following plan types should give you a better idea of what plan makes the most sense for you:
- Indemnity (Fee-for-Service, or FFS) Plans: These medical plans offer the greatest flexibility in choosing your doctors. The limitation with Indemnity plans exists in the amount of the reimbursement that an insured party can receive to cover medical expenses. The medical expense reimbursement amount can range from a per day cost and set percentage to the actual costs of the medical expenses.
- Preferred Provider Organizations (PPOs): These plans contract with a network of hospitals and doctors who provide services at a negotiated rate. This means you have access to any PPO provider in the network, whether a primary care physician or specialist. PPO members can go to doctors or hospitals that are not in the network but will have to pay a higher cost for doing so. This is a great plan if you are looking for insurance that is both affordable and flexible.
- Health Maintenance Organizations (HMOs): With these managed care plans, you will have a primary care physician (PCP) who is responsible for managing all of your health care. If you need to see a specialist or someone else in the network, you need a referral from your PCP. Treatment received outside the network is generally not covered, or is covered at a significantly reduced level.
- Point of Service (POS) Plans: These medical plans are a combination of the PPO and HMO models. Like an HMO, there is a PCP providing referrals to in-network doctors. Like a PPO, you can see providers outside the network and pay more of the cost.
Obamacare and Individual Health Insurance
The Affordable Care Act, also known as Obamacare, has caused significant changes to your health care coverage. Here are some things you need to know about how Obamacare has impacted individual health insurance:
Don’t Sweat Pre-existing Conditions: It used to be difficult to get health insurance coverage if you had been previously treated for significant medical conditions. Now, pre-existing conditions are no longer a concern. However, in order to encourage people to buy health insurance before they need it, there are now only certain times of the year, known as Open Enrollment Periods, when you can purchase a long term insurance plan.
Fortunately, if you have life changes that are considered a Qualifying Life Event, such as getting married, having a baby, or involuntarily losing your current health insurance, you may be able to purchase the coverage when you need it. If you do not have a Qualifying Life Event, you can purchase a Short Term Health Plan to get the coverage you need, right away, regardless of Open Enrollment.
Multiple Levels of Coverage: Other than catastrophic coverage, which is a plan limited to those with a financial hardship or are under the age of 30, there are four main levels of coverage: bronze, silver, gold, and platinum. The metals make it easy to remember the different types of coverage available: bronze has the least expensive premiums, while platinum has the most expensive. However, the more you pay for the premiums, the less you will have to pay for out of pocket costs like deductibles, copays and coinsurance. Bronze plans pay for 60% of expenses, silver 70%, gold 80% and platinum 90%.
Health Savings Accounts: You can also purchase a high deductible health plan within the Bronze or Silver category, and then use a health savings account (HSA) along with it. Your HSA allows you to put away money tax-free to pay for qualified medical expenses.
For more information about Individual Health Insurance, please see our Frequently Asked Questions section. If you want to learn more about how Obamacare has impacted Individual Health, please see our educational guide.
We can help you find an individual health insurance plan that is right for you. Contact us today to find out what is the best individual health insurance for your budget and needs!