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Individual Health
Why choose an Individual Health Plan?
No Access to Group Health Plans
You may work for a company that does not offer an employee health plan.
You may work part-time and not be qualified for the company plan
Self-employed but rates are too high
As a self employed business person, you have access to several group plans, however, your health history is excellent, your needs are minimal, and the group plan premiums are higher than you would like.
Group access but contribution too high
Your employer offers a plan, however your contribution is more than you can handle. You might find that an outside individual plan would better fit in your budget.
Prefer tax advantages and savings plans
Your IRAs and 401Ks are maxed out and you need a way to save more money in tax deferred accounts, the HAS (formerly MSA) style plans mean lower premiums as well as a way to increase your income tax deductions by making contributions to the savings plan.
Definitions:
A health plan that is not dependent upon a business entity to qualify for
coverage.
The amount of medical expenses paid before insurance kicks in
Shared expense after the deductible is met; typically 80/20 where the
insured pays 20% and the company pays 80%
Number of family members to which deductible and Coinsurance applies:
most common is 3X, meaning if 3 family members meet limits, they are
waived for additional family members.
A plan which utilizes a Preferred Provider Organization; use is optional,
however, services are provided at discounted rates.
Out Of Pocket expenses, combining deductibles and coinsurance and X
Factor; individual products have OOP Caps.
Health Savings Account where insured may set aside funds for future
medical expenses, (OOP) which funds are tax deductible and earn interest.
HSA style plans feature combined deductibles and coinsurance, with no X
factor, for lower premiums.
The act of measuring risk to determine premium; with health insurance,
this requires a family health profile and may require presentation of health
records.
A partially subsidized health insurance plan for people who do not have
access to group plans and have been disqualified from individual plans. |
