Finding an Insurance Plan to take you on as an Individual Policy


My basic advice is simple. Ask everyone you know who has an individual plan. Then call those insurance companies, but also call companies you don’t think have individual plans.

About 18 years ago my husband and I were suddenly without group health insurance.

There were a lot of plans out there for individual policies. Most required truly high deductibles and co-payments at whatever medical facility one used. They usually were tied to limited facilities and one “prime” physician. Getting to a specialist of any kind required even more referrals, and much more paperwork, than anyone wants to consider. And yes, I know that HMO’s typically are set up this way, even with the best insurance companies.

There still are “old-time” policies out there, but it takes a bit of digging to find them.

What I ended up doing was calling a number of well-known health care insurance companies. Most of the larger insurance companies do have individual plans. Some are about the same as the smaller companies and self-employed “groups” that offer health care plans.

When you read the rates, also factor in the deductibles, whether you have a choice of physicians and if you must have a referral to see anyone except your primary doctor (even another general practitioner).

Try to make sure you can have an “emergency” in a city or state where you aren’t tied to a primary physician. This can be a nightmare. One daughter did finally get her ER bill and specialist consultant paid when it happened to her, but it took almost eight months before her insurance paid. And hers was a group plan, not an individual policy.

After probably 10-12 phone calls, I somehow connected with the right person at the right time. I found a Blue Cross/Blue Shield individual policy that, at the time, actually cost about $100 less than our former group plan per month.

It had a flat $200 deductible to be paid upfront. We could send in any prescription costs (always ask about this!) and those applied toward deductible.

Once the $200 was met, we went to an 80/20 schedule. Insurance paid 80%. We paid 20%. This was around $2,200 that we’d paid out-of-pocket for the year. After that we had 100% coverage. We had to send prescription costs in but those were covered either at 80% or 100% with refund checks.

When my husband died, my single policy went down – for a while. As I aged, my costs went up, my payments climbed, but were still more than comparable with similar policies.

Until 2007, I’d only met my 100% deductible one time when I had a “minor” surgery.” In other words, I came out a bit beyond “even” since my single private insurance was costing more than $300 a month by that time. (It climbed to more than $400 before I reached 65, but even group plans charge for being older).

In late 2006 I developed cancer. After 2007, the policy paid far beyond anything I have paid for health care insurance in my life. During my worst months, some “scan” and other “test” bills were around $15,000. That was per month, not year.

My late husband and I could have chosen a cheaper individual policy with less comprehensive coverage. I’m glad we did not. No one knows when catastrophic health care will be needed. With no questions asked, all paperwork completed elsewhere.

Make sure any policy you pay hundreds a month for will cover the evil times! And keep calling insurance companies until you find the one that costs comparable to what you probably are paying for less coverage now. Always, always, always, try to get a policy over which you have control of which doctors you can see without undue paperwork.

I could not have dealt with the paperwork and trials of a smaller policy for 2006-2008. Now…I’ve reached Medicare age, and I have few options.

I’m sorry, the government has made such a snarl about getting decent coverage with it that I’m just glad that, at least temporarily, my health is better and I can face both paperwork and a whole lot of telephoning to straighten out bills.

As long as you can, control your health care insurance. Check out even unlikely sources for individual policies. But also choose wisely. Cheapest sometimes is not best.