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Your Step-by-Step How to Choose Your Own Health Insurance Plan
Buying your own individual or family health insurance plans can seem intimidating—you don’t have the luxury of having your company, union, or government-sponsored program pick out a health insurance plan for you. But just because you’re new to the health insurance game doesn’t mean you can’t get a quality plan at a price you can afford.
How to find a family or individual health insurance plan on your own
The good news for you is that, in most areas, there isn’t a lack of options on the health insurance market for those buying their own health insurance plans. If you are willing to do some research and take the time to seek out your options, you might just find the individual health insurance plan or family health insurance plan you were looking for.
A good way to get some help is to buy your individual health insurance plan from an online health insurance broker like eHealth. We have over 10,000 individual health insurance plans from over 180 different insurance providers, which is likely the biggest selection of health insurance products you’ll find online. By shopping on eHealth you can also get free quotes and speak to licensed agents who can guide you through the process of purchasing an individual health insurance plan. Watch this video to see some ways that eHealth will simplify your shopping
Types of family and individual health insurance plans
When buying your own health insurance, the options are very similar for individual health insurance plans and family health insurance plans. What changes is your needs, so it may help to know the general details of how each plan works, in order to make a good decision based on your health-care needs. For example, if you are a family with several children, you probably have different health insurance concerns than a single individual in his or her twenties.
The table below illustrates what types of insurance plans there are, including both comprehensive major medical health insurance plans and alternative products that provide much less coverage.
A major medical plan is a type of health insurance that meets all standards of the Affordable Care Act (ACA) and provides benefits for a wide range of health-care services. If you are looking for comprehensive access to health care for you and your family, then you probably want to shop for this type of plan. The types of plans are available both on government exchanges and from non-government sources such as eHealth.
Catastrophic and Short-Term plans are great options if you’re looking for temporary or partial coverage outside of open enrollment period, because these supplemental insurance products are available even outside of the open enrollment period. However, these products do not meet the requirements of the ACA. This means they are often cheaper than ACA plans, but they may not cover the minimum essential health benefits of ACA plans (including preventive care), may exclude pre-existing conditions, do not qualify for government subsidies, and otherwise have significant limitations compared to ACA plans.
What types of individual and family major medical plans are there?
Major medical health insurance plans come in several different formats. In order to make shopping for your own family or individual health insurance plan easier, take a look at this table to see what you generally get with
When can I enroll in health insurance?
If you’re buying an individual health insurance plan, you’ll generally need to enroll during the open enrollment period, which usually happens towards the end of the calendar year. For example, if you want to buy health insurance for 2019, the open enrollment period is scheduled to run from November 1, 2018 until December 15, 2018.You may be able to get a major medical health insurance plan outside of the open enrollment period if you have a qualifying life event (QLE).If open enrollment has passed, and you don’t have a QLE (such as the birth of a child, divorce, etc.) then there are alternative products on eHealth.com like short-term health insurance. You may find that buying a product like short-term health insurance and pairing it with more alternative products can be a good form of coverage if a major medical plan is not an option. See plan details for important limitations.Where can I see these options? Visit eHealth.com to find an individual health insurance plan or family health insurance plan that suits your health-care needs and your personal budget. Based on the information you provide, you will be shown options that are available to you in your area.You can also speak to a licensed representative or use eHealth’s chat function if you have any questions about either individual health insurance plans or family health insurance plans.Don’t be intimidated about shopping for your individual health insurance plan or family health insurance plan! With access to free quotes and licensed representatives showing you quality plans, you’ll be able to find the right plan for yourself or your family in no time.
Here's what to ask before you sign up:
1. Does the plan include my doctor, clinic and hospital?
A health insurance plan works with a network — a group of doctors, clinics, hospitals and other health care professionals. Usually, you pay less when you see a provider in your plan network. Be sure to find out if your providers are in the plan network before you enroll. You will pay more for services you receive outside your network.*
Learn more about networks
2. Does the plan cover my ongoing medical needs?
Consider the type of coverage you'll need for treatments you will start or continue in the future. Find out if the plan covers the services you need, and if it will cover them as often as you need them.
3. Does the health plan cover me while traveling?
Some health plans have networks that include providers throughout Minnesota. Others include providers in specific counties. If you need health care outside of your plan’s service area, you might not have coverage.
4. Does the plan work with a health savings account (HSA)?
Some health plans include HSAs that you can use to save and pay for health care.
See 6 benefits of a choosing an HSA plan
5. Does the plan cover my prescription drugs?
Prescription drug coverage varies by health plan. For example, some plans have a copay or coinsurance for covered drugs. This means you pay part of the cost for covered drugs and the plan pays the rest. With some health plans, you must first pay a deductible before the plan begins to pay.
Generally, health plans have a list of drugs they cover. This list is known as a formulary. Typically, plans will not cover drugs that are not on the formulary. Be sure to check the plan formulary to make sure the plan covers the drugs you take.
6. Is my pharmacy in the network?
Health plan networks usually include several pharmacies where you can fill prescriptions. Check to make sure the pharmacy you prefer is in the plan network. If you visit a pharmacy outside the plan network, you will pay more — and possibly the full cost — for your prescription drugs.
7. Does the plan offer support to help me make decisions about my health?
Taking care of your health is important. Find out what tools and support the plan offers to help you get and stay healthy. Here are a few questions to ask:
- What tools and resources does the plan offer to help you stay healthy and keep medical costs down?
- Does the plan offer a 24-hour nurse line or online doctor care?
- Are there tools to help you compare costs and quality of doctors and hospitals, so you can find the best value?
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