Protecting Those You Love the Most

FAQs About Individual Health Insurance

Do you need individual health insurance? If you recently left your job and your employer-sponsored policy is about to end, take a look at what you need to know about your coverage options and how to choose an individual health insurance provider.

Do You Need Health Insurance? 

You should have health insurance. According to the U.S. Centers for Medicare and Medicaid Services, the federal tax penalty for lack of insurance coverage is no longer applicable. But some states may have their own insurance mandates and penalties. Before you drop your coverage, make sure to learn more about your state's health insurance regulations and laws.

If your state doesn't require insurance, you still may need a policy. Even though you may feel healthy right now, an accident, sudden illness, or major injury could result in thousands of dollars worth of hospital, doctor's office, imaging, lab, or physical therapy expenses. Without insurance, you'll need to pay out-of-pocket for the full cost of any medical treatment or service. 

Are All Private Policies the Same?

All private insurance policies are not the same. You have options to choose from. These include the company that provides coverage, the premium (the amount you pay per month), the deductible (the dollar amount you pay before the insurance covers your health care costs), copays (the amount you pay per doctor's office visit or service), and the types of amounts of coverage. 

How Should You Choose A Private Policy?

There isn't one way to choose an insurance policy that works for each individual. Before you select a policy, think about how much you can reasonably pay for a monthly premium. Higher deductible policies usually come with lower premiums. This can save you money upfront. But if you need medical care for an illness or injury, you could pay much more in out-of-pocket expenses. 

Along with the premium and the deductible, ask each potential insurance company for a list of in-network or covered providers. These could include primary care physicians (PCPs), specialists, hospitals, medical facilities, and therapists (such as counselors, speech therapists, occupational therapists, or physical therapists). 

Visits to or care from out-of-network providers typically come with a higher out-of-pocket cost. This means you will pay more to see your regular PCP who is out-of-network for one insurer than for an insurer who considers the doctor in-network. If you don't mind switching doctors or hospitals or you don't already have a PCP or specialists you see regularly, the in-network versus out-of-network issue won't significantly affect your choice of insurer. 

Contact a local individual health insurance provider to learn more.