Health Insurance Made Easy

Personal health insurance is coverage obtained by an individual for themselves and their family, as opposed to via an employer. This sort of insurance gives individuals greater flexibility over their coverage options and can be especially beneficial for those who are self-employed, unemployed, or who are not offered coverage via their employer.

When acquiring individual health insurance, it is essential to understand the many plan options, including HMOs, PPOs, and HDHPs. Each type of plan has its own set of perks and restrictions, so it is essential to examine coverage alternatives and pick the plan that best meets your needs. In addition, it is essential to comprehend the numerous variables that can affect the cost of individual health insurance, such as age, location, and health condition.

Below, we provide information on the various types of available plans, how to compare and select the best plan for you, and ways to save money on your individual health insurance costs. Whether you are purchasing health insurance for the first time or seeking to switch from employer-sponsored coverage, we will assist you in navigating the process and locating a plan that matches your needs and fits your budget.

What kinds of health insurance are there?

There are essentially two kinds of heath insurance: Fee-for-Service and Managed Care. Although these plans differ, they both cover an array of medical, surgical and hospital expenses. Most cover prescription drugs and some also offer dental coverage.

1. Fee-for-Service
   These plans generally assume that the medical professional will be paid a fee for each service provided to the patient. Patients are seen by a doctor of their choice and the claim is filed by either the medical provider or the patient. 
2. Managed Care
   More than half of all Americans have some kind of managed-care plan¹. Various plans work differently and can include: health maintenance organizations (HM0s), preferred provider organizations (PPOs) and point-of-service (POS) plans. These plans provide comprehensive health services to their members and offer financial incentives to patients who use the providers in the plan.

What is ‘long-term care’ insurance?

Because of old age, mental or physical illness, or injury, some people find themselves in need of help with eating, bathing, dressing, toileting or continence, and/or transferring (e.g., getting out of a chair or out of bed). These six actions are called Activities of Daily Living–sometimes referred to as ADLs. In general, if you can’t do two or more of these activities, or if you have a cognitive impairment, you are said to need “long-term care.”

Long-term care isn’t a very helpful name for this type of situation because, for one thing, it might not last for a long time. Some people who need ADL services might need them only for a few months or less.

Many people think that long-term care is provided exclusively in a nursing home. It can be, but it can also be provided in an adult day care center, an assisted living facility, or at home.

Assistance with ADLs, called “custodial care,” may be provided in the same place as (and therefore is sometimes confused with) “skilled care.” Skilled care means medical, nursing, or rehabilitative services, including help taking medicine, undergoing testing (e.g. blood pressure), or other similar services. This distinction is important because generally Medicare and most private health insurance pays only for skilled care–not custodial care.

What are the types of disability insurance?

There are two types of disability policies: Short-Term Disability (STD) and Long-Term Disability (LTD):

1. Short-Term Disability policies (STD) have a waiting period of 0 to 14 days with a maximum benefit period of no longer than two years. 
2. Long-Term Disability policies (LTD) have a waiting period of several weeks to several months with a maximum benefit period ranging from a few years to the rest of your life.

Disability policies have two different protection features

1. Non-cancelable means the policy cannot be canceled by the insurance company, except for nonpayment of premiums. This gives you the right to renew the policy every year without an increase in the premium or a reduction in benefits. 
2. Guaranteed renewable gives you the right to renew the policy with the same benefits and not have the policy canceled by the company. However, your insurer has the right to increase your premiums as long as it does so for all other policyholders in the same rating class as you.

Things to consider when purchasing an insurance policy:

• Additional purchase options
  Your insurance company gives you the right to buy additional insurance at a later time for an additional cost.  
• Coordination of benefits
  The amount of benefits you receive from your insurance company is dependent on other benefits you receive because of your disability. Your policy specifies a target amount you will receive from all the policies combined, so this policy will make up the difference not paid by other policies. 
• Cost of living adjustment (COLA)
  The COLA increases your disability benefits over time based on the increased cost of living measured by the Consumer Price Index. You will pay a higher premium if you select the COLA.  
• Residual or partial disability rider
  This provision allows you to return to work part-time, collect part of your salary and receive a partial disability payment if you are still partially disabled.  
• Return of premium
  This provision requires the insurance company to refund part of your premium if no claims are made for a specific period of time declared in the policy. 
• Waiver of premium provision
  This clause means that you do not have to pay premiums on the policy after you’re disabled for 90 days.

Frequently Asked Questions About Health Insurance

What types of health insurance plans are available for individuals?

Individual health insurance is offered in a variety of forms, including HMOs, PPOs, and HDHPs. Each type of plan has its own set of perks and restrictions, so it is essential to examine coverage alternatives and pick the plan that best meets your needs.

How can I sign up for individual health coverage?

Individual health insurance enrollment normally entails filling out an application, submitting income verification and other information, and paying the first month’s premium. Typically, enrollment periods occur around specified times of the year.

What variables affect the cost of health insurance for individuals?

Numerous factors, including your age, location, and health status, might affect the cost of individual health insurance. In addition to the type of plan you select and your eligibility for government subsidies, the cost of coverage can also be affected by other factors.

What is an individual health insurance deductible?

A deductible is the amount that must be paid out of pocket before insurance coverage kicks in. It is the amount a person must pay before insurance begins to pay for covered services.

How can I select the individual health insurance plan that best meets my needs?

To choose the best individual health insurance plan for your needs, it is essential to carefully research coverage options and compare plans from various providers. It’s also a good idea to seek specific recommendations from a healthcare professional or insurance representative.

Are there any available government subsidies for individual health insurance?

Yes, those who fulfill specific income and eligibility conditions are eligible for government assistance. These subsidies can reduce the cost of individual health insurance for people who qualify.