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Health Insurance for Individuals

Importance of Health Insurance for Individuals and Ideas on How Best to Choose Affordable Individual Health Insurance Plans

Not having health insurance can make you financially susceptible to the health hazards that life can throw your way. However, for many Californians, health insurance is not readily available. The number of uninsured people has risen significantly over the past few years, partly because fewer employers offer group health plans, and many families make too much money to qualify for state Medicaid.

That leaves many residents with limited coverage options. Without state or employer health coverage, only private health insurance for individuals is available. Private health insurance is insurance coverage that you purchase yourself outside of a group plan. Unlike employer coverage, private health insurance requires you to submit to an underwriting process to determine whether you qualify for benefits, and at what cost.

Underwriting is a process that carefully calculates your likelihood of filing future health insurance claims by examining your previous health history, lifestyle habits and current health conditions. It will also consider your age, weight and gender. Depending on the insurer to which apply for coverage, you may be offered health insurance at preferred rates, escalated rates, or you may be denied coverage altogether.

It is important to keep in mind that individual health insurance plan is different. There are health plans that cover major medical conditions only at low monthly premiums, and there are also comprehensive coverage plans that pay for prescription medications and doctor's office visits. In choosing an insurer, select the company that best fits you and your family's needs. Some things to keep in mind include:

- Are your family physicians in-network under your plan?
- Can you afford the annual deductible?
- Are there limits to the number of office visits covered each year?
- Is your deductible an individual or family deductible, or both?
- Does your health plan qualify you to open a health savings account?
- Will you have to pay an application fee?

Once you have determined which insurance plans best fit your needs, shop and compare quotes for each plan. Keep in mind that if you are in the market for private health insurance, self-employed, and without access to an employer's health plan, you can qualify to deduct your and your family's private health insurance premiums on your federal income tax returns each year. If you are not self-employed, premiums are fully taxable.

Know Your Rights

There are many laws surrounding health insurance for individuals in California and throughout the U.S. You may be entitled to certain benefits without knowing it. For example, have you recently lost your job? If so, you may be entitled to continued COBRA coverage through your previous employer's group health insurance plan according to the federal Health Insurance Portability and Accountability Act.

Continuing Coverage

Once you are approved for health insurance coverage, your insurer cannot cancel your coverage due to new health conditions that may arise. Your insurer also cannot place a limit on your lifetime benefits. The only grounds in California on which an insurance company can cancel coverage is due to fraud or failure to pay monthly premiums. Your plan may also be canceled if your insurer is no longer providing coverage in your state.

Pre-Existing Conditions

Despite the federal upholding of The Affordable Care Act, as of 2012, adults in California can still be denied health insurance in the individual market for the presence of pre-existing conditions. If you are turned down for health coverage due to a past or present health condition, you still have options. You can continue to apply for coverage from other insurance providers, or you may enroll in the California high-risk insurance pool, where you cannot be turned down because of your health. California high-risk insurance premiums are calculated based on the age of the applicant, but are typically higher than rates on the private market.

Future Changes to Individual California Insurance Plans

In the future, all California residents will be required to purchase health insurance for individuals. If your employer does not offer coverage, you will be required to purchase benefits on the private market. However, beginning in 2014, you will no longer be denied coverage for pre-existing conditions, nor will you be charged higher rates because of your health. Insurers will no longer implement annual coverage limits, and depending on your household income, you may qualify for certain tax benefits designed to make the cost of your private insurance premiums more affordable.

 
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