What You Should Know When Looking for Individual Health Insurance

Unfortunately, acquiring health insurance has become a very confusing subject. It might even be as confusing as taxes—maybe more so in some situations. Each year, it seems more laws affect an individual, family, or business trying to obtain health insurance for the first time or when they are trying to get better insurance.

When a person is trying to get individual health insurance, they can become paralyzed by all the new information they have to digest to find a plan that will serve their needs. There are so many choices and variables that it’s hard for an individual to know if they are getting a good deal. If this sounds like the experience you’re having now or have had in the past, I hope you’ll keep reading because I might be able to simplify the subject a little bit.

Going Online for Individual Health Insurance

There are many websites trying to attract your attention to get you to come to their website to sign up for health insurance. This is where most people who are under 65 start looking. But it’s hard to evaluate if you are getting the best coverage for yourself when all you’re doing is answering the questions provided on the website. It’s hard to compare coverages from different plans. It’s even difficult to know what’s most important to look for when signing up for a plan, unless you are an expert.

Most people are pretty nervous when they contemplate committing to insurance this way, whether it’s for themselves or their families, because they really can’t know for sure if their coverage is the best they can get or if they will get hit with unexpected costs. All this talk about co-pays, deductibles, coinsurance, and maximum out-of-pocket expenses can be baffling.

Am I right?

What You Need to Know Before Applying for Health Insurance

Before applying for health insurance, whether it’s online or with an insurance consultant like me, you should be ready to answer the following questions.

  1. What is the estimated taxable income for the current year for the entire household? This is the most important single datum affecting your insurance. If you are going to qualify for a subsidy under the Affordable Care Act, this number should be as accurate as possible. Please note that you don’t look at last year’s tax return for this number, this estimate relates to the income for the year you are in when looking for insurance. Also, the income for the whole household must be estimated, even if insurance is just being sought for an individual in that household.
  2. Which doctors do you want to see? If you have certain practitioners that are important to you, then you need to know which insurance company’s network those doctors are in. List the practitioners you need access to.
  3. Who is going to be covered? A single person? Family? Minor children or children over 18 but younger than 26?
  4. Which prescriptions need to be covered?
  5. What are the medical histories of those to be covered? Under the Affordable Care Act, individuals must be able to obtain medical insurance even if there are preexisting conditions.
  6. Are any surgeries anticipated?
  7. Is anyone planning to retire soon?

When you have this information in hand, it’s important to check each insurance plan you’re considering to see if your doctors are in the plan’s network, prescriptions are covered, and procedures are insured. To avoid surprises like finding out you don’t have coverage you need, you must check each of these points.

For most people trying to work their way through the labyrinth of new health insurance applications, it can take three, four, or more hours to get through this process. It can take even longer if they are trying to verify coverages and networks as I just mentioned. Begin the process of applying for health insurance by collecting this information for each person who needs coverage, and you should have everything you need to get started.

My Help Is Available!

I’ve been helping people with insurance for more than 20 years. As I work with clients on their various insurance needs, I’ve seen clearly that so many of them needed help navigating this health insurance labyrinth! That’s why I started MBhealth, to make it simpler for individuals and families to get the right coverage. If you need someone to look out for you, not the insurance companies, give me a call at (314) 544-5400.

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