Individual Health Insurance
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Understanding Health Insurance Options for Individuals

Even though more and more employers are offering health insurance plans, there’s still a need for affordable individual health insurance. After all, not everyone’s employer will offer health coverage and even if they do, it may not be the best coverage for you. 

There are many reasons to want to buy individual health insurance and we’re here to help make sure you can get it at a reasonable rate. 

Just keep reading. Here’s what you need to know about health insurance options for individuals. 

What Is Individual Health Insurance Coverage?

Individual health insurance coverage is insurance that you don’t buy through a government-run plan (CHIP, Medicare, Medicaid) or through your employer. 

It’s insurance you purchase on your own, for yourself or your family. So, the “individual” part of individual health insurance coverage refers to the individual act of acquiring the insurance: It doesn’t necessarily have to be just for you. 

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Who Needs Individual Health Insurance Coverage?

Excellent question, because not everyone needs to—or should—go this route. Individual health insurance coverage is best suited to the following people:

  • Those without employer-based health insurance;
    OR those for whom employer based health insurance does not cover their dependents;
    OR those for whom it is cost-prohibitive when extended to dependents;
    OR those for whom it is cost-prohibitive in general. In some cases, thanks to subsidies, you may be able to get more affordable individual health insurance through a marketplace ACA plan.
  • Those who retired too early for Medicare.
  • Those who are self-employed.

There are some other situations in which someone may choose to buy individual health insurance, but these are by far the most common ones.

What’s Included In Individual Health Insurance Coverage?

Individual health insurance providers must, according to ACA standards, provide the following in all individual health plans. 

Outpatient care that includes physician’s visits
Emergency room care
Hospitalizations
Pregnancy and maternity services
Mental health and substance abuse services
Prescription drugs
Services and devices for recovery
Laboratory tests
Preventative services like screenings, immunizations, and birth control

However, it is important to note that you are responsible for ascertaining if your provider is ACA-compliant. Not all private insurance options are, such as short-term health insurance, which can deny you coverage based on pre-existing conditions.

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Where To Buy Individual Health Insurance?

You can buy individual health insurance both on-exchange (through the marketplace via HealthCare.gov) or off-exchange. However, if you buy individual health insurance off-exchange, premium tax credits and cost-sharing reductions are not available. 

When To Buy Individual Health Insurance?

Regardless of where you buy individual health insurance, the fact remains you can only get it during the open enrollment period, which runs between November 1 and December 15th, or during a special enrollment period, which is triggered by a life event like the loss of a job (and related insurance), divorce, or the birth of a child. 

Types of Individual Health Insurance Coverage

Under the ACA, there are five types of health plans: platinum, gold, silver, bronze, and catastrophic.

Platinum plans pay 90% of your health care costs, and you pay 10%.

Gold plans pay 80% of your health care costs, and you pay 20%.

Silver plans pay 70% of your health care costs, and you pay 30%.

Bronze plans pay 60% of your health care costs, and you pay 40%.

Catastrophic plans are designed for people 30 years of age or under who are experiencing financial hardship. These plans typically pay less than 60% of your total health care costs.

As you’d probably guess, the higher the metal rating and the more covered by the insurer, the higher the premiums—but again, you may qualify for subsidies that can significantly reduce costs.

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The Cost of Individual Health Insurance Coverage

The cost of individual health insurance coverage will vary widely from person to person depending on factors like your provider, lifestyle, age, health, and zip code, so it’s impossible to tell you exactly how much it will cost you

All this said, in 2020, the average cost of individual health insurance, without subsidies, was $575/month. Subsidies (i.e. tax credits) can bring this down to roughly $491/month.

Individual health insurance is often lower than employer-sponsored plans (which averaged $623/month in 2020). However, this is the cost before your employer picks up part of the cost, which they almost always do. With this portion covered, employees typically pay $104/month. 

You can also get short-term health insurance as an individual coverage option but if you qualify for a subsidy through an ACA plan, then this choice will likely yield more affordable individual health insurance. 

Do I Need to Buy Individual Health Insurance?

No, but you need to buy some type of health insurance so that you’re covered in case anything should happen to you. Yes, it’s an expense, but if you get individual health insurance quotes, then you’ll be able to rest assured that you are paying the best possible price.

Request and fast and free quote here, from us. We’ve curated a list of the best individual health insurance plans from the most trusted and affordable providers and will match you with your ideal carrier. It’s that simple.

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Questions?
Open enrollment for ACA compliant health care plans begins November 1st and ends December 15th for coverage beginning January 1st of the following year.
Picking a plan under the Affordable Care Act has only three factors that impact rates: age, smoker/non smoker and location. All other costs are determined by your choice of insurance product. The insurance products are ranked based upon your exposure to out of pocket expense.
You can get individual health insurance coverage both on and off-exchange. Finding the best for you is a matter of shopping around a little, and getting quotes from reputable carriers. You can start by getting a free individual health insurance quote from us here and now.