Most people have health insurance through their job, a spouse’s job, Medicare or other group health insurance. If you find yourself without, however – because of a job loss or other reason – it’s time to shop around for individual health insurance. (Note: Individual health insurance is not just for individuals. You can purchase an individual policy for a family as well.)
First, if you’re leaving a job, keep in mind that you might be eligible for COBRA insurance. COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1985) means that most employers that offer group health insurance must make that same insurance available to employees who leave their job, for up to 18 months. However, COBRA can be expensive since the employee pays the full premium plus an administrative fee. You have 60 days after leaving a job to choose to enroll in COBRA – coverage is retroactive – and it can serve as a stopgap measure while you search for other insurance.
There are many independent health insurance plans, as with group plans: health maintenance organizations (HMOs), point-of-service (POS) plans, preferred provider organizations (PPOs) and fee-for-service (FFS, or indemnity) plans. Each has different options, so before you start shopping for insurance, answer the following questions:
- What do expect from your health insurance plan? Is the plan just for you, or for your entire family? Do you tend to go to the doctor frequently, or not at all?
- Is cost or flexibility more important to you? How important is it to you to choose your own primary care doctor? Your specialists?
- How much can you afford to spend on health insurance? Starting with a realistic budget might narrow your options. Humana and advocacy group Consumer Action have teamed up to provide a health budgeting tool called Family Health Budget to help consumers.
Once you’ve answered these questions, it’s time to shop around! It’s important to get several quotes from various providers, since costs for the same coverage can vary widely. To do this, find a professional health insurance agent who can narrow your options and steer you in the right direction. Start by asking friends and family for referrals. You can also check out the Association of Online Insurance Agents for agents in your area.
It’s a good idea to vet any potential insurance agent through the Office of the Commissioner of Insurance in your state (in Michigan, the Office of Financial & Insurance Services. Make sure your agent is licensed and specializes in health benefits.
When making the final decision regarding any insurance plan, make sure you completely understand all aspects of the plan and read the fine print. You should know deductibles, exactly what the policy covers – including procedures such as mammograms and x-rays – and it should cover major medical expenses such as hospitalization. Know when the policy takes effect. Many do not start right away, which can affect decisions you make regarding end-of-employment dates and COBRA, if applicable.
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