Individual/Family Health Insurance Plans
Versus
Company Sponsored Group Health Insurance Plans
Advantages of purchasing health insurance in the individual market:
- Cost – Typically, insurance purchased in the individual market is less expensive than company sponsored group health insurance.
- Choice – Choose any company, any deductible and any coverage you want. Individual health insurance policies are unlike group plans where your employer makes the selections for you. You can also choose copayment amounts for office visits and prescription drugs. You can choose among different networks.
- Payments – Pay monthly, quarterly, semi-annually or annually in the individual health insurance market. Premiums for group plans are deducted per paycheck.
- Adult children can remain on an individual health insurance policy regardless of full-time student status.
- Short-term health insurance policies are available for people who are between jobs or in a probationary period waiting for group benefits.
Disadvantages of purchasing health insurance in the individual market:
- Pre-existing medical conditions – Pre-existing medical conditions may be excluded from coverage and may cause an increase in premium. If the condition is severe enough, you may be declined altogether from coverage. If there is a lapse of more than 63 days in coverage, the insurance company can choose to exclude the pre-existing condition for up to 12 months in the individual health insurance market.
- Maternity benefits – Maternity is typically not a covered expense in individual health insurance plans. Some companies allow you to add maternity benefits but impose time restrictions and significantly increase the premium.
- Cost sharing – Employers do not offset the cost of premiums on individual health insurance plans as they do in company plans.
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