Buying health insurance as part of a group plan when you’re fully employed is normally at a lower rate than independent coverage. If you’re between jobs, and can not continue with your former plan, a new group health plan may not be an option. If you decide to work as an independent consultant between full-time jobs, you’ll notice a sharp rate increase if/when you buy individual health insurance coverage.
Individual health insurance plans are purchased directly from the insurance carrier by the individual, and do not offer benefits normally tied to a full-time workplace. However, individual plans can cover you and your family members. Keep in mind there are other ways to get health insurance when you’re between group health plans, including “short-term” and “catastrophic” health insurance plans.
Individual plans are “medically underwritten”, which means the insurer may reject your application, if you have existing health problems. Some states don’t allow this practice and require that insurance carriers offer you a policy, no matter what your medical condition. A list of “Guaranteed Issue Laws” has been published by the Kaiser Family Foundation, so do your homework before you let a carrier reject your desired policy application, or make exclusions to it.
Individual plan buyers pay premiums determined by their “expected” health care costs, so prices will be higher as they grow older and/or less healthy. But don’t let any confusion tempt you to go without health insurance. Healthy or not, you could have a serious accident, and, as many others are, be forced into “medical bankruptcy.”
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).
If you’re uninsured and have a “pre-existing condition”, you may feel like a reject from the health insurance market. It may seem to be impossible or unaffordable. But there are practical ways you may be in a position to manage to get coverage.
If you are a self-employed, sole proprietor, even home-based, you need to do your research carefully. Because in some states, you can be eligible to buy health insurance as a “group of one”. All you need is proof that you’ve been in business for at least 30 days.
If the state in which you live does not offer these “group of one” insurance policies, you may still qualify for a group rate if you own a business and have at least one partner or employee. Is your spouse helping you with your home-based business? Then you qualify as a two-person business, and are eligible for a group rate and a group policy.
Let’s say you’re planning on leaving an employer where you have a group health plan. Simply ask the insurer to convert it to an individual health plan. The rate will, of course, be higher than your group plan, but at least you’ve secured your health insurance if you have medical conditions. Another option to check on: if your spouse has a group plan at work, you might be able to be added on to it.
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