How to Choose an Individual Health Insurance Plan

April 13, 2017

Finding a health care plan to suit your needs can be a frustrating experience.


Most people receive their health insurance benefits through their employer or their spouse’s employer. Unfortunately, not everyone falls into that category.

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What if you’re “in-between”?

If you’re between the ages of 50 and 65, you may find yourself in an unenviable situation.

There are some obstacles to getting health insurance coverage that those in this particular age bracket face:

  • Finding a company that will cover you, especially if you have already had a medical condition of some sort.
  • Getting coverage may require submitting yourself to a physical exam in order to prove that you are healthy.
  • The rates may be higher than what you are used to when you had prior group plan coverage.
  • Along with paying more, you may have less coverage.

These challenges necessitate spending some time researching and comparing different available plans. At this initial stage, be sure to make sure the plans you are interested in are offered in your area. Plans do vary depending on the state in which you live.

Choosing a plan

Be thorough in vetting a healthcare plan for yourself and your family. Consider these elements as you are making your decision.

  • The amount of medical care costs that will be covered. Think about doctor visits as well as possible hospitalization. Find out what your co-pay will be for regular doctor visits, as well as for emergency room and specialist visits.
  • The premiums. Make sure the amount you’re required to pay for the plan fits into your budget. Some of this will depend on the deductible, which is discussed next.
  • The deductible. You have to consider how much you can afford to pay out-of-pocket before your insurance kicks in. A higher deductible will translate into a lower monthly premium and vice-versa.
  • Preventive care. While each plan will offer preventative care, find out exactly what that means for each individual plan.
  • Pre-existing conditions clause. Some plans will not provide coverage for you if you have a chronic condition or a serious medical problem.
  • Dental, vision and prescription coverage. You may have to purchase these services separately if you can’t find a plan that includes it for a price that fits your budget.
  • Limits. Sometimes a policy can have limits as to how much you would have to pay out-of-pocket in a year or a yearly or lifetime limit that the insurance carrier will pay.
  • Providers and specialists. It’s very important that you make sure there are providers who accept your plan in your area before you purchase the policy.

Getting some clarity

Finding a plan that fills the gap before you’re eligible for Medicare can be a challenge. There’s a lot to understand and an abundance of plans out there. It can be hard to determine which one is just right for you.

If you find yourself becoming overwhelmed by all the options, consider getting some help.

An independent healthcare insurance agent has some distinct advantages over trying to go it on your own.

The job of an agent is to know the details of healthcare plans and to determine which one is best for you. Not only will she understand, she knows how to explain things to you in a way that helps you make sense of it as well.

In addition, an independent agent can act as an advocate for you if issues arise or you need to make changes or updates to your policy.

The InsureOne Benefits team is happy to help you navigate the sometimes murky waters of healthcare plans.

Call today and let us guide you into a plan that works for you!