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Buying Individual Health Insurance

Staying healthy is something a lot of us take for granted and only realize how serious the consequences of being ill can be when it happens to us. This articles covers helps those not covered by health insurance to find their own policies.

Americans worry about a whole list of potential threats, such as terrorist bombs, air crashes, homicide and lightning strikes but, statistically, the top five causes of death and serious harm in the USA are all medical in nature.

You have a 1-5 chance of dying from a heart attack, cancer takes 1 in 7 of us, strokes 1 in 24, infections picked up in hospital 1 in 38 and common influenza kills 1 in 63 US citizens.

Given these figures it is obviously essential to have health insurance to cover the medical costs incurred or to provide for your family in the event of your death.

What is individual health insurance?

95% of Americans have health cover through their employer or a government health insurance program. If you are self-employed or do not have a current work health scheme you can buy insurance as an individual.

The laws governing group and individual health insurance differ from state to state but, as individual cover is often more price sensitive, the policies tend to be simpler and provide less comprehensive cover. Benefits that may be considered “standard’ in a group policy, like maternity coverage or substance-abuse treatment, may not be included in an individual plan, although you may have the option to add this cover, known as an optional rider, for an extra premium.

On the plus side, because the policy is for an individual, you can probably find cover that is tailored to your individual health requirements and budget. You can check the detail of each state’s requirements for individual health insurance policies by looking at the NAHU Health Care Coverage Options database (www.nahu.org).

How can I buy individual health insurance coverage?

Because individual health plans vary so much in the cover they offer and the restrictions they impose it is necessary to shop around. Quotations may vary by as much as 50% from one provider to another for what is essentially the same policy.

How are premium rates determined?

There is a very handy health care insurance calculator at Money-Zine.com which can help you through the complicated task of working out how much your cover will cost. Always check the following:

Does the plan cover prescriptions and X-rays?
Do I prefer certain specialists? Some plans limit not only your visits but also which doctors and specialists you can be treated by.
Does the plan cover ‘alternative treatments’ Acupuncturists or chiropractors may not be covered by a standard plan so, if you want to see one of these be sure to check the policy. Psychotherapy and other mental health services are also likely to have specific limitations.
What will it cost me for emergency care? Emergency care can be the most costly health care you have so it is important to read the fine print and check you are covered for such contingencies.

Are any pre-existing medical conditions covered?

Be aware that many insurance policies will excluded pre-existing medical conditions. The law differs from state to state on who will be accepted by the insurance company. The insurer may reject your application or attach exclusions to your policy if you have existing health problems. Some states don’t allow this practice and require that health insurers offer you a policy, no matter what medical problems you have. Even in this latter case insurance companies are allowed to look back at your medical history for pre-existing conditions and may elect not to cover certain conditions for a specified period of time.

Thirty-three states provide cover to those people who find it impossible to get insurance, so the chances are that you will be able to find a policy to cover you, although your choice will be limited and premiums will be higher.

If you have serious health conditions you can see if Blue Cross will insure you. If you operate a business out of your home, or are an independent contractor, or self-employed it’s possible that your local Chamber of Commerce may be able to help you.

The good news is that American life expectancy has never been higher, with men living to a record 75.3 years and women to just over 80. Having comprehensive health insurance is one of the factors that will help make sure that you reach, or beat that average figure.

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