Individual Health Insurance FAQs
If you are thinking about obtaining health insurance for yourself or your family, you may be interested in the answers to the following frequently asked questions:
Why Do You Need Health Insurance?
Health care costs are higher than they've ever been, and, as the population ages and as medical research and technology continue to get more sophisticated, health care costs will continue to be a challenge. If you have a serious accident or a major illness, how will you pay your health care bills? You buy health insurance for the same reason you buy other kinds of insurance, to protect yourself financially. With health insurance, you protect yourself and your family in case you need medical care that could be very expensive. BACK TO TOP
Are You Eligible for Coverage?
Individual plans are available to those from age 0 thru age 65. Once a person turns 65, he or she becomes eligible for Medicare and must forfeit their individual health insurance policy.
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Are You Guaranteed Coverage?
Your ability to obtain individual health insurance from a private insurance company depends on the status of your health. Insurance companies that offer health insurance plans to individuals and families may decline to offer you coverage if you have certain health conditions or because of other factors, such as your height and weight. A carrier may also place special limitations on your coverage if you have certain health conditions.
When seeking coverage on your behalf, we work diligently to identify the carriers that are likely to provide the most favorable response to your request for coverage, based on your health status. BACK TO TOP
How Is Your Premium Determined?
The premiums that are charged for individual health insurance are based on several factors, including your age, your health status, your zip code and your lifestyle habits. Smokers will typically pay more for health insurance than non-smokers, as will people that are overweight or have pre-existing conditions. BACK TO TOP
Are Your Pre-existing Conditions Covered?
Unlike group health plans, individual health plans generally do not give you credit for prior coverage. For this reason, in most cases, your individual health plan will have a 12-month waiting period for pre-existing conditions.
In addition an insurer can attach an amendment or "exclusionary rider" to your health insurance that excludes coverage for an existing health condition for a specified period of time or permanently. BACK TO TOP
Can Your Individual Policy Be Canceled?
Assuming that you pay your premium in a timely fashion, and that you have answered questions about your health status fully and accurately on your application for coverage, your coverage cannot be canceled, should you become ill. However, guaranteed renewability does not protect you from having your premiums increase at renewal, and premiums can also increase within limits as you age.
If your claims exceed your plan's maximum lifetime benefit, the insurance company may cease paying benefits. When this occurs, your policy will terminate.
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