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.
While individual health insurance plans are purchased directly from carriers, leaving out the employer middle man, they do not offer the fuller range of benefits and lower rates associated with the typical workplace group plan. However, individual plans may cover you, your spouse, and your children. The two other main methods to get an individual health insurance plan when you're not fully employed with a group health plan are to obtain either "short-term" and/or "catastrophic" coverage.
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."
So don't lose your rights to coverage of pre-existing conditions. Don't go without insurance for 63 days or more, a time period set by the Health Insurance Portability and Accountability Act (HIPAA).
You may feel locked out of the health insurance market if, for example, you've been uninsured for too long, or have a "pre-existing condition". It may seem impossible, there are practical ways you may be able 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.
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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