It’s easy to think that the only way of getting health care is through your employer. But for many Americans, that either isn’t possible or isn’t the best option.

Why you might want individual health insurance

The most common customers for Individual Health Insurance are those who aren’t employed by a big corporation. If you are self-employed or working for a small business, then you likely won’t be able to get corporate health insurance. Individual Health Insurance becomes the obvious choice, because it’s the only choice.

Individual Health Insurance Plan Coverage
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But there’s a second group, the people who are eligible for a corporate plan, but choose to go it alone. There can be many reasons for this.

If you change jobs frequently, you might well be better off getting a plan of your own, rather than trying to deal with corporate plans that change every couple of years.

Or, you might just not like the corporate plan. Since corporations are buying for hundreds or thousands of people at once, they can tend to go for the ‘lowest common denominator’, leaving some of the more health-aware employees feeling that the cover is inadequate.

Whatever the reason, choosing an Individual Health Insurance plan is a difficult decision, but one that can bring you great peace of mind and a lot less damage to the wallet than you might expect. The key is to know how to go about choosing a plan…
Types of plan

In many ways, the dangers and pitfalls of Individual Health Insurance are parallel to those for any other form of health insurance. That means you can apply the same advice you’ve read about other kinds of insurance to it.

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There are a great many people and organisations who can help you with information relating to your particular circumstances, ranging from your own family and friends to non-profit organisations and independent financial advisors. But here’s an overview of some questions you should be asking about any Individual Health Insurance plan.

Managed Care or Fee for Service ? These are the two broad categories of insurance which you need to think about. Under a managed care scheme, if you fall ill you will be treated in a facility run by your insurer.

Under a Fee for Service plan you can go to any doctor (there are always exceptions, remember…), and then you pass their bill on to your insurer.

As is almost always the case, each of these schemes is good for some people and bad for others. If you have established good relations with local doctors, then a fee for service plan will let you stick with them – although be sure to check that your preferred doctors are acceptable to your insurer, or you could end up with some nasty administrative headaches later on)

More isn’t always better…

Each of the two main types of plan can be more or less inclusive. You’ll want to look in detail at exactly what is covered by your Individual Health Insurance policy.

Bear in mind that more isn’t always better. If something is in the policy, you know that you’re paying for it in your premiums. There are two sets of cases where you don’t want benefits.

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One is when you know you’ll never use the benefit – for example if you’re male, there is no point choosing an Individual Health Insurance policy which gives excellent gynecological care (unless the policy extends to cover your wife, of course). Be careful – there aren’t many things that you know you’ll never want.

The second is areas that you have covered through other means, either by paying for treatment yourself, or because you have a specialised policy to cover it. A typical example would be dental care.

Many people already have a specialised dental insurance policy, and if this is the case then there is no use buying an Individual Health Insurance policy which also covers dental care. Another big area of overlap is fitness and nutrition advice.

This can be a big benefit for some people – but if you are already a member of a gym, you can often get equally good fitness and nutrition advice through that route.

…But usually it is

So, there may be times when a policy becomes less attractive through offering benefits you won’t need. But in general, of course, you’re looking for the policy that gives you the most benefits at the lowest price.

Exactly what matters to you will depend on your circumstances, but here are some things to ask about. Is dental care included? Teeth can be extremely expensive to look after. Are prescription fees paid?

If you are looking at a Fee for Service plan, how free a choice do you have in deciding what doctor to go for? Is psychiatric help included? And so on, and so on, and so on – various non-profits and advisors will give you checklists of things to ask for, but your best option is to draw up your own, based on what you think is important.

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