Reasons people buy individual health coverage?
Insurance reforms have made it easier for individuals to get and keep insurance coverage.
For example:
- Self-employed people may be able to deduct up to 100 percent of their self-employed health insurance premiums on their federal income tax returns.
- Health plan companies may not refuse to renew an individual (non-group) policy as long as you pay your premiums; this is known as guaranteed renewal.
- In general, starting September 23, 2010 health plans must cover children with preexisting conditions who are under 19 years old. This coverage will not apply to everyone until 2014. This is part of the new federal health reform law and applies as plans renew or are issued. This law does not apply to grandfathered individual market plans (individuals covered in non-group plans in effect March 23, 2010). See www.healthcare.gov for more information. Please note: Some health plans no longer offer "child only" policies for children under 19 years old. They do cover these children under "family" policies which cover the child (children) under 19 and at least one adult.
- Other than for children under 19 years old (see above), limitations for preexisting conditions may be in place for no more than 12 months except that groups may exclude coverage for late entrants for up to 18 months. A late entrant is someone who declined coverage at an initial, open or special enrollment period and who then asked to be covered. Consumers may change health plan companies and receive credit for any preexisting condition limitation they have already met as long as they maintain continuous coverage. A new insurance company may not impose another limitation if they have already satisfied the 12-month preexisting condition limitation. This helps people who wish to switch jobs and keep adequate coverage.
- Women cannot be charged more for health coverage than men of the same age.
- Dependents can stay on their parent's health plan until they turn 26 years old under the new federal health reform law unless it is a grandfathered plan. In most cases the new law applies as plans are issued or renewed. See www.healthcare.gov. Grandfathered plans are plans that were in effect on March 23, 2010 and they do not have to meet some of the requirements of the new health reform law. Under Minnesota law dependent children of any age who are disabled can be covered by their parent's policy. Minnesota law does not apply to most self-insured plans.
- Recommended preventive care must be provided by certain health plans without charge to the enrollee when the enrollee sees an in-network provider. See www.healthcare.gov. This includes some screenings, vaccinations, and counseling. Required by the health reform law, in most cases the new law applies as plans are issued or renewed. Ask your insurer or health plan administrator whether these benefits apply to your plan and when they begin.
- Insurance companies cannot deny payment and cancel the enrollee's coverage due to errors or mistakes on enrollee's application. Effective for health plan years beginning on or after September 23, 2010.
What questions should I ask before I make a decision?
Before making a decision about what to choose, you may want to get answers to the following questions:
- Can I stay with my current provider or clinic?
- Does the health plan utilize a network of providers? Is my provider part of that network?
- Will I have free choice of all type of providers?
- Will I be required to get a referral to see specialists?
- What happens if I live part of the year in a different state?
- Will this plan cover expenses when I am traveling?
- If my children attend school outside Minnesota, what coverage will they have while at school?
- What will my total cost be each year?
- Are there deductibles? What is the maximum out-of-pocket costs? Are there copays? Is there coinsurance?
- What services does the policy cover? Does it cover prescription drugs? Does it cover outpatient care or home care? Are there limits on the number of days the company will pay for these services?
Tips for shopping for health coverage
- Sully. Coverage and costs vary from company to company and policyhop caref to policy. We are in business to help you compare policies.
- Read and understand the policy. Make sure it provides the kind of coverage that’s right for you. Do not buy anything until you have had all your questions answered.
- Check to see when your coverage will begin (some policies have a waiting period before coverage begins) and whether any of your preexisting conditions will be covered.
- Make sure there is a “free look” clause. Most companies give you at least 10 days to look over your policy after you receive it. If you decide it is not for you, you can return it and have your premium refunded.
- Beware of single disease insurance policies. There are some policies that offer protection for only one disease, such as cancer. If you already have health insurance, your regular plan may provide all the coverage you need. Check to see what protection you already have before buying any more insurance.
Checklist: What Is Most Important to You??
Please click the button below to open up a policy self-analysis in another window or tab (depending on your browser). The checklist is provided to assist you in comparing plans. First check the services most important to you. Then compare the coverage for these services in the plans you are considering. After you're done you can either keep the checklist window or tab open for your reference or print the page for your convenience. We hope you enjoy the feature.
Service Checklist
More than 40 million adults stated that they needed but
did not receive one or more of these health services (medical care, prescription medicines, mental health care, dental care, or eyeglasses) in 2005
because they could not afford it. Source: National Center for Health Statistics