Health Insurance for Individuals: If you are an individual not covered by a group health insurance plan, self employed, laid off etc., you may need to go to for a health insurance plan for individuals. They are essentially of two types – Indemnity (fee for service) and managed care plans (HMO, PPO, POS). Te major difference is in the choice of health care providers, out-of-pocket expenses, and how the bills are paid.
COBRA: Individuals who are laid off or become self employed on own choice, it is possible to extend their employer-sponsored health coverage through COBRA. The Consolidated Omnibus Budget Reconciliation Act of 1985, allows workers to extend those benefits for up to 18 months after leaving a job. The only downside is the erstwhile employer will no longer pay their portion of the premium, which is typically 75 to 80% of the total cost of the plan.
Pre-existing conditions: You may be denied individual coverage if you have any pre-existing conditions that may disqualify you. Under COBRA, you will continue to get coverage for the permitted duration. Unfortunately this threat of losing insurance under such situation makes many people not to choose self-employment and continue in an unfulfilled job. Proposed recent regulations suggest doing away with pre-existing conditions.
Broad things to look for while considering individual health insurance quotes: a) Understand the different types of policies available, b) Research the companies offering the insurance, c) Checkout the agent, d) Make sure you know what the policy will pay for and it what it will not, e) Determine how the reimbursement actually works for visits, prescriptions, and other services.
Tax deductions: Thanks to recent federal initiatives, it is possible for the self-employed to deduct the cost of their health insurance premiums from their federal taxable income. However, the deductions can’t exceed the income resulting in a business loss.
Guaranteed Issue: If you line in states like New York, which is a “guaranteed issue” state, insurance companies doing business there must offer you an opportunity to purchase insurance regardless of your previous health history.
Need for Continued Coverage: In a few states, eligibility is restricted to those who have continued insurance coverage. If you have discontinued your insurance plan, it becomes difficult to get fresh insurance. Hence before you drop an insurance coverage you may already have, please consult a health insurance professional regarding this in your state.
Health saving account: Explore use of health savings account with a health insurer. This allows you to roll over cash from your health savings account when you have take care of hospital bills. Be wary of low premium, high deductible health policies. They may appear to be saving money on lower premium, but you may have to pay higher costs when you avail the health benefits.
Integrated disability insurance: This is useful feature to have when you get injured and become unable to work productively. It is not found in all health insurance plans for individual products though they are common among group insurance products and in recent times more and individual plans also have started offering this.
Supplemental health insurance: While choosing health insurance for individuals determine what are the risks not covered in the regular plan and consider supplemental plans. Be careful to consider non overlap between the regular plan and supplemental plans.
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