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Understanding your health insurance

Last Updated: July 15, 2005
Page: 3

Individual Insurance

If your employer does not offer group insurance, or if the insurance offered is very limited, you can buy an individual policy.

Insurance is provided through two major sources:

Public -- Medicare for the elderly, Medicaid for the disabled or needy, Veteran's Administration for those who have served in the Armed Forces, and Champus for Military Families or

  • Private --- Includes insurance provided for by private companies


    • Commercial Insurance Companies
    • Nonprofit Insurance Companies and
    • Self-insured Groups (employers who pay benefits directly rather than using an insurance carrier).

You can get a Fee-for-service plan, HMO, or PPO protection. But you should compare your options and shop carefully because coverage and costs vary from company to company.

Individual plans may not offer benefits as broad as those in group plans. If you get a noncancellable policy (also called a guaranteed renewable policy), then you will receive individual insurance under that policy as long as you keep paying the monthly premium.

The insurance company can raise the cost, but cannot cancel your coverage. Many companies now offer a conditionally renewable policy. This means that the insurance company can cancel all policies like yours, not just yours.

This protects you from being singled out. But it doesn't protect you from losing coverage. Before you buy any health insurance policy, make sure you know what it will pay for...and what it won't.

To find out about individual health insurance plans, you can call insurance companies, HMOs, and PPOs in your community, or speak to the agent who handles your car or house insurance.

Tips when shopping for individual insurance:

  • Shop carefully. Policies differ widely in coverage and cost.
  • Contact different insurance companies, or ask your agent to show you policies from several insurers so you can compare them.
  • Make sure the policy protects you from large medical costs.
  • Read and understand the policy.
  • Make sure it provides the kind of coverage that's right for you. You don't want unpleasant surprises when you're sick or in the hospital.
  • Check to see that the policy states: the date that the policy will begin paying (some have a waiting period before coverage begins), and what is covered or excluded from coverage.
  • 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 polices that offer protection for only one disease, such as cancer. If you already have health insurance, your regular plan probably already provides all the coverage you need.
  • Check to see what protection you have before buying any more insurance.

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