Health Insurance

Individual health insurance is coverage purchased by an individual or a family and is not tied to a job or a group of policyholders.  
 
Many people get health insurance through their employers. However, if you do not currently participate in your employer’s health plan, or if your employer doesn’t offer coverage, obtaining individual health insurance may help you pay less out of pocket for medical care. 

Individual Health Insurance Plans 

 

An individual health insurance plan is purchased independent of an employer. You can purchase individual health insurance plans through your state’s health insurance exchange or directly from an insurer. 
 
Talking with a Max Value Insurance Group agent is a great first step in determining the right coverage for your needs and budget. We have a variety of coverage options and the expertise to guide your choices.  
 
There are also other ways to seek individual health insurance, including those listed below.  
 

Obtain Insurance in the Individual Market  

 

The Health Insurance Marketplace (also known as the exchange) are some of the most common places to buy health insurance and apply for Medicaid. Created by the Affordable Care Act (ACA), the marketplace is designed to help you quickly find health insurance that fits your budget. Different states may have other available options. There is also a federal marketplace at HealthCare.gov.  
 
Qualified health plans in the marketplace are sold and run by private companies. Every plan covers a core set of 10 essential health benefits, including emergency, prescription drug and mental health services. Additionally, all plans offered in the marketplace must provide free preventive care, with 100% of the costs paid for by insurance companies.  
 
 

Get on Someone Else’s Plan  

 

If your spouse or domestic partner has an employer-sponsored plan open to participants’ family members, consider joining and enrolling your children.  
 
Additionally, the ACA extends coverage eligibility for young adults up to age 26 on plans offering dependent coverage, regardless of their marital or student status.  
 

Gain Insurance Through Protections Under HIPAA  

 

Under the Health Insurance Portability and Accountability Act (HIPAA), at least one private insurer must sell you a policy if you meet all of the following conditions:  
 

• You previously had 18 months of coverage without a break for more than 63 days.
• The last day of your coverage was through your former or current employer.
• You do not have a COBRA or mini-COBRA option available. 

 

Use Medicaid or Other State Programs  

 

Medicaid provides health coverage for some low-income individuals, including families and children, pregnant women, the elderly and people with disabilities. People who do not qualify for full Medicaid benefits may still be eligible for breast cancer and cervical cancer screenings or assistance with certain treatments.  
 
The rules for Medicaid enrollment differ slightly from state to state. You can visit www.medicaid.gov or use your state’s marketplace to determine whether you are eligible for Medicaid coverage in your state. You can also consult your local health department to see if any public coverage options are available in your area.  

Seek Insurance Through COBRA and State-sponsored Programs  

 

The Consolidated Omnibus Budget Reconciliation Act (COBRA) provides certain former employees, retirees, spouses, former spouses and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events, such as having reduced work hours and subsequently losing employer-based coverage.  
 
COBRA coverage is usually more expensive than health coverage for active employees, so individuals may wish to consider other options, such as an exchange plan, if they ever lose their employer-sponsored coverage.  
 

How Much Is Health Insurance? 

Health insurance costs vary according to numerous factors, which may include the ages and number of people you want to be covered by a plan and the type of coverage you choose. Your agent can help you understand which health insurance options may fit your budget.  

 

What Is a Deductible in Health Insurance? 

 
Your health insurance deductible is the amount you must pay out of pocket each year before the health insurance plan starts paying for covered medical services. After you satisfy your annual deductible, you may continue to pay certain costs, such as a copayment or coinsurance for covered services, when you receive healthcare. Some plans cover certain services, such as preventive services and checkups, before you meet your annual deductible.  

Conclusion  

With all the different health plans available, it can be challenging to select the plan that best meets the needs of you and your family—your budget. While it can be tempting to pick the plan with the lowest premium, you don’t want to be surprised by high out-of-pocket costs or network restrictions when seeking medical care.  
 
Speak with Max Value Insurance Group for assistance in determining your best available health insurance options.