Finding The Right Health

Insurance Plan For You

1 Size Does Not Fit All

Finding The Right Health Insurance Plan For You

Health insurance coverage and associated costs vary greatly based on whether the insurance is an individual policy (for the self-employed/unemployed), for a small business (from 2 to 50 employees), or for a large group. Coverage for group plans is far more comprehensive and considerably less expensive, because there are more people paying into the insurance pool, making more money available group-wide to cover medical claims.

Individual Policies Hard To Find

Those who try to get health insurance on their own, either because their employer does not offer this benefit or because they are self-employed or unemployed, often have difficulty obtaining health insurance. Many simply cannot find an insurance company in their state that is willing to offer individual plans. Pre-existing conditions complicate this search and put individuals into a 'high-risk' category. It's often the reason coverage is denied.

Those who are fortunate enough to find individual coverage don't feel so fortunate once they review the policy details. They typically find that the cost is significant and the coverage less than desirable and loaded with out-of-pocket costs. Those who obtain health insurance on their own can usually purchase a family plan, but then the costs are even higher.

Small Business Health Plans

Those individuals who are employed by small businesses also find themselves in a difficult situation when it comes to health insurance. If the employer chooses, it may offer a group type of health insurance for employees.

When applying for coverage, the overall costs will be based on the number and physical condition of all the employees who wish to participate. High-risk individuals and those with pre-existing conditions will bump up the costs for everyone. Even so, the costs for this type of coverage will usually be better than if each employee obtained an individual policy. Employers are not required to cover other family members and can choose the percentage of the employee's costs that they will cover.

Group Health Insurance

Group health insurance generally offers the best coverage at the most affordable price. Group insurance is available to all eligible employees of the company offering the health insurance, and generally includes the employee's immediate family members, spouse and/or children. A group plan must accept every eligible employee even if the person has a known pre-existing condition and even if that person or his/her family members fall into a high-risk category.

Weigh Costs Against Benefits

Whether you need private health insurance when you already have a group health plan is not an easy question to answer. To adequately assess this situation, you've got to review your group insurance coverage and compare it to what you need.

Some group health insurance plans exclude certain medical services such as dental and vision care, experimental treatments, cosmetic surgery, some mental and substance abuse therapies and more, so you may find you need to complement your group plan with a private health insurance plan. In doing so, you'll incur more costs, so you'll have to weigh the additional benefits against the additional costs to see what makes sense for you.