Independent Health Insurance

If you leave your job — or start another one that doesn't offer independent health insurance — you may be surprised at just how expensive the same coverage is when you buy independent health insurance.

An independent plan is one purchased on the private market, not tied to workplace benefits. Although they are called "independent" or "individual" plans, they can cover you, your spouse and your children.

There is no guarantee that an insurer will accept you for an independent policy. independent plans are medically underwritten and the insurer may reject your application or attach exclusions to your policy if you have health problems. Under "guaranteed issue" laws, some states don't allow this practice and require that health insurers offer you a policy, no matter what medical problems you have. The Kaiser Family Foundation has a list of guaranteed issue laws.

People enrolled in Anthem Blue Cross independent plans pay premiums determined by their expected medical care costs, so prices will be higher for those who are older and/or less healthy.

Pricing is probably the most bewildering aspect of independent health policies, so it's worth your time to comapre your health plans online. To compare Anthem Blue Cross plans online visit our Plan Finder.

If you're faced with finding independent health insurance, don't let any confusion tempt you to go without. Even if you're healthy, you could fall off a ladder or have a serious car accident and be forced into "medical bankruptcy."

Plus, you'll lose your rights to medical coverage of pre-existing conditions if you go without insurance for 63 days or more, a time period set by the Health Insurance Portability and Accountability Act (HIPAA).

How to choose an independent health plan

When shopping for an independent health insurance policy, it pays to do your homework. According to Cheryl Leamon, spokesperson for Anthem Blue Cross Blue Shield , ask yourself these key questions:

 

• What is my household's current and anticipated health care need? Consider the services you and your family will need on a regular basis. If your child has asthma, will he have to see an asthma specialist routinely to keep it under control?

 

• What will my out-of-pocket expenses and monthly premiums cost? Does it make sense for me to pay a higher premium for lower out-of-pocket costs? If you want a comprehensive health plan — and don't want many of out-of-pocket expenses — an HMO provides a very cost-effective plan. But if you're in your 20s or 30s, have no children and some extra savings, you can possibly save money by buying a policy that covers only catastrophic illnesses. Remember, though, you'll have to pay out of your own pocket for routine doctor visits and laboratory test.

  To estimate health plan costs, try this health care insurance cost calculator from Money-Zine.com.

   

• Does the plan cover prescriptions? Prescriptions are one of the most used benefits of health plans. Review the coverage of any health plan to determine if your current prescriptions are covered.

 

• Do I prefer certain specialists? Some plans limit not only your visits but also who you can see. If you want to see an acupuncturist or chiropractor, be sure to ask your insurance agent about coverage for these services. Psychotherapy and other mental health services will likely have specific limitations as well.

 

• What do I look for if I can't afford a policy that covers routine care? Look for comprehensive inpatient/outpatient plans with higher deductibles rather than cutting back on hospital/surgical plans. A basic hospital/surgical plan might cost less, but if you end up in the hospital, the last thing you need to add to your list of worries is how you're going to pay for follow-up care once you're released.

 

• What will it cost me for emergency care? Look at what costs, including co-pays or coinsurance, or services such as hospital and surgery care, apply towards the deductible. Leamon advises looking at what defines "emergency care" in your policy.

  "Some policies may pay for a broken leg or an injury due to an accident, but won't cover an illness you were treated for in the emergency room. And still, other more affordable plans will cover a visit to the emergency room, but not an extended stay in the hospital. Since emergency care can be the most costly in any independent health insurance, it is best to read the fine print," she says.