How to Buy Individual Health Insurance Coverage at Group Rates
Oct 31st, 2009 Posted in insurance | no comment »Group health insurance, as part of a group plan at a full-time job, is generally offered at lower rates on premiums compared to individual health insurance coverage. But if you leave your job – or start another one that doesn’t offer health insurance, a group health plan may not be an option. And you may be surprised at just how expensive the same coverage is when you buy individual health insurance.
An individual plan is one purchased on the private market, not tied to workplace benefits. Although they are called “individual” plans, they can cover you, your spouse and your children. Other ways to buy health insurance when you’re between group health plans include “short-term” health insurance and “catastrophic” health insurance.
“Medically underwritten” individual plans allow the insurer to reject your application or attach exclusions to your policy if you have a “prior existing condition”. So there is no guarantee that an insurer will accept you for an individual policy. Under “Guaranteed Issue” laws, some states require that health insurance carriers issue you a policy, no matter what medical problems you have. Do your homework and check the list of “Guaranteed Issue” laws for your state. The Kaiser Family Foundation has published a list of these laws.
Even though people enrolled in individual health insurance plans pay more as they grow older and more prone to illness, don’t let that tempt you into to going without coverage. Even if you’re healthy you could have a serious or near-fatal accident and be forced in “medical bankruptcy” as so many millions of others are each year.
It’s important for you to keep in mind that you’ll lose your rights to coverage of pre-existing conditions if you go without insurance for 63 days or more, a time period set by the Health Insurance Portability and Accountability Act (HIPAA).
Already sick with a “pre-existing condition”? If you’re uninsured, it may seem to be impossible or too costly to buy health insurance. But there are practical ways you may be able to get coverage This will require researching a few basic situations.
Double check the facts in your state because, in some states, self-employed sole proprietors are eligible to buy independent health insurance at the premium rate of a “group of one”. Even if you are a home-based businessperson you may do so, if you can show that you’ve been in business for 30 days or more.
You might qualify for a group rate if you own a business and have at least one partner or employee, even if you live in a state that does not offer these “group of one” insurance policies. For example, does your spouse do some bookkeeping or any other business-related tasks for your company? That setup qualifies you as a two-person business, and therefore makes you eligible for a group rate policy.
Before planning to leave an employer with which you have a group health plan, call and inquire as to whether their insurance carrier can convert it to an individual health plan for you. Even though the rate will be higher than your employer’s group plan, it’s your best option, for the time being, to secure health insurance. This is most important for those with existing medical conditions. Also inquire as to whether your spouse has a group plan at their work, and if they can add you on.
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