Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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Individual Health Insurance BasicsIndividual health insurance is a type of coverage that you buy yourself, as opposed to coverage obtained through an employer or government program.

It is estimated that about five percent of the population buys their own health insurance — that’s more than 15 million Americans!

Read through the below guide to the basics of individual health insurance and then get started finding the best health plan for your needs!

Who is individual health insurance for?

This type of health insurance is most ideal for those who are:

  • Employees of a company that does not provide health insurance benefits
  • Those between jobs and without health insurance
  • Recently unemployed and find COBRA is too expensive
  • Self-employed individuals looking for health insurance
  • Recent graduates not covered under their parent’s plan

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What are the benefits of individual health insurance?

The great thing about shopping for an individual health plan is the variety of affordable health insurance options available to pick and choose from. With the guidance of a licensed health insurance agent, you can figure out what your needs are and how to find benefits that can meet them.

Some benefits to consider are: pre-natal visits, maternity care, well-baby visits, prescription drugs, routine doctor’s visits, etc. You can also decide what is more economically feasible for you: paying for a high deductible and low monthly premium or vice versa.

If you recently become unemployed, an individual plan is likely cheaper than the high premium cost of continued employer coverage via COBRA.

What are the risks of having an individual health insurance plan?

The drawback is that you may pay higher premiums because you are solely responsible for your plan’s premium, versus having your employer pay some or all of the premium cost, as with group employer coverage. Also, premiums vary from state to state because of differing state health care usage histories or certain statewide legislative requirements.

Moreover, premiums are determined by expected health care costs, so individuals who are sick, smokers, or older can expect to pay more. Of course, if you are relatively healthy then individual health insurance may be much cheaper than a similar group health insurance plan!

The reason why individual health plans can be so much cheaper is that individual health plans are medically underwritten, meaning an insurer can deny or apply exclusions/rate-ups to your policy if you have pre-existing conditions.

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OK, now how do you actually buy individual health insurance?

Buying the perfect individual health plan is a lot easier than you would think, and can be done best with the help of a licensed agent. Just enter some basic information about yourself in online to view side-by-side comparisons of plans in your zip code. Licensed agents can explain your state’s law and walk you through the entire process—from shopping for plans to completing your application and receiving your policy. Comparison shopping health plans online is free, so there’s no reason why you shouldn’t take advantage of it.

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What impact does health care reform have on individual health plans now, and in 2014?

The following changes will be implemented beginning September 2010:

  • New plans must cover some preventative services without cost sharing
  • Insurance companies can’t drop you when you’re sick, due to a mistake you made on your coverage application
  • Carriers cannot impose lifetime maximums on your coverage
  • New individual plans can’t deny or exclude coverage to any child under age 19 due to health conditions (this includes babies born with health problems)
  • If a new plan doesn’t pay for services you thought were covered, you have new options to appeal the decision

Beginning in 2014, individual health plans cannot turn down individuals with a preexisting condition (including a disability).

Why not start comparing free individual health insurance quotes online now?