Choosing Individual Health Insurance

Choosing health insurance can be a daunting task, to say the least.  With so many carriers to choose from and even more plans than you can wrap your head around, it may be hard to make a decision.  What should you look for in health insurance?

In order to find the right fit, you must first evaluate your insurance needs.  Are you looking for something that provides comprehensive coverage, including office visits and major medical?  Or are you looking for something to cover hospitalization only?  Thinking of things you might need in the future is important, but it’s also important to evaluate your needs today. 

While it may be tempting to choose a plan with lots of bells and whistles, you must pay close attention to your operating budget.  How much can you afford to spend? Before you start your search, it’s best to know exactly what you are working with.  

Many plans offer higher deductibles, which affords lower premiums; and lower deductibles, which will drive the cost of the premium up.  Would you rather pay on the front end or on the back?  If you choose a plan with a higher deductible, it might be a good idea to set aside funds for the deductible, just in case.  Most plans require the deductible to be satisfied before the plan begins to pay, better to be safe than sorry. 

For the most part, you will use your insurance coverage for office visits and prescriptions.  Some plans limit the number of office visits allowed per year, so consider the amount of visits you had in the previous year when making your decision.  Brand-name medications often require a separate prescription deductible, if you are currently on any medications this will be very important to you. If you are unsure, call your pharmacy to see if your medications are brand or generic.  If there are generic alternatives available for your brand name prescriptions, it might be a good idea to switch (consult with your physician first).

If you have a family or looking to start one, look for a plan that offers maternity benefits.  In the past, maternity benefits were standard, but that has changed.  These days, the mass majority of plans do not offer maternity coverage at all and the ones that do can be pricey.  If this is important to you, choose a plan the covers prenatal visits and labor and delivery.  

Pay close attention to the pre-existing clauses.  Although anyone can apply for individual health insurance, not everyone will be approved.  While healthcare reform promises to end pre-existing discrimination, the law has not taken effect yet.  If you have any chronic conditions (high blood pressure, asthma, diabetes, etc.) do your research.  There are some states that will accept you with proof of credible coverage (meaning you were insured within the last 63 days or less), most will not.

In a perfect world, health insurance would be free and easy to understand.  Unfortunately, health insurance has become confusing and convoluted with politics.  Choosing the right plan takes a time and a lot of research, but with patience you can find a plan that meets your needs.