Individual and Family
Buying your own individual or family health insurance plans can seem intimidating—you don’t have the luxury of having your company, union, or government-sponsored program pick out a health insurance plan for you. But just because you’re new to the health insurance game doesn’t mean you can’t get a quality plan at a price you can afford.
The good news for you is that, in most areas, there isn’t a lack of options on the health insurance market for those buying their own health insurance plans. If you are willing to do some research and take the time to seek out your options, you might just find the individual health insurance plan or family health insurance plan you were looking for.
A good way to get some help is to buy your individual health insurance plan from an online health insurance broker like eHealth. We have over 10,000 individual health insurance plans from over 180 different insurance providers, which is likely the biggest selection of health insurance products you’ll find online. By shopping on eHealth you can also get free quotes and speak to licensed agents who can guide you through the process of purchasing an individual health insurance plan. Watch this video to see some ways that eHealth will simplify your shopping experience.
When buying your own health insurance, the options are very similar for individual health insurance plans and family health insurance plans. What changes is your needs, so it may help to know the general details of how each plan works, in order to make a good decision based on your health-care needs. For example, if you are a family with several children, you probably have different health insurance concerns than a single individual in his or her twenties.
The table below illustrates what types of insurance plans there are, including both comprehensive major medical health insurance plans and alternative products that provide much less coverage.
A major medical plan is a type of health insurance that meets all standards of the Affordable Care Act (ACA) and provides benefits for a wide range of health-care services. If you are looking for comprehensive access to health care for you and your family, then you probably want to shop for this type of plan. The types of plans are available both on government exchanges and from non-government sources such as eHealth.
Catastrophic and Short-Term plans are great options if you’re looking for temporary or partial coverage outside of open enrollment period, because these supplemental insurance products are available even outside of the open enrollment period. However, these products do not meet the requirements of the ACA. This means they are often cheaper than ACA plans, but they may not cover the minimum essential health benefits of ACA plans (including preventive care), may exclude pre-existing conditions, do not qualify for government subsidies, and otherwise have significant limitations compared to ACA plans.
Major medical health insurance plans come in several different formats. In order to make shopping for your own family or individual health insurance plan easier, take a look at this table to see what you generally get with each type of plan:
|Type of plan||Plan characteristics|
|Preferred Provider Organization (PPO)||Under a PPO plan, you and your family can see any healthcare provider in the insurance company’s network, including specialists, without a referral. In most cases, you are not required to choose a primary care physician. You will typically have copayments for any non-preventive medical care you receive, and you may have an annual deductible. In some cases, you can go outside of the network for a higher copayment.
Individuals who visit a specialist regularly may prefer this type of health insurance, since you won’t have to deal with getting referrals. This is also a great option if you have a doctor who you want to stay with, and you don’t want to risk paying completely out-of-pocket if he or she isn’t in the network.
|Health Maintenance Organization (HMO)||HMOs are one of the most popular types of health insurance you can purchase. With this plan, an entire network of healthcare providers agrees to offer you its services, but you have to select a primary care provider (PCP) who coordinates all of your health services and care.
HMOs usually offer coverage for most types of preventive care, including specialist visits, but in most cases, specialist visits can only happen with a referral from your PCP. Additionally, you will pay copayment fees for every non-preventive medical visit, and you may have an annual deductible. HMOs might have lower costs than some other types of major medical plans.
HMOs are usually best suited for individuals and families that want to save money and don’t mind using a limited provider network.
|Exclusive Provider Organization (EPO)||With an EPO plan, you have access to all of the healthcare providers within the EPO network, including specialists. Whereas PPO plans may offer you some coverage outside of your network, EPO plans typically will not (except for emergencies).
EPO plans can be suited well to individuals who don’t mind limiting themselves to providers within a network and who don’t want to coordinate their care through a primary care doctor.
|Point of Service (POS)||POS plans are a hybrid of HMOs and PPOs. With a POS plan you will typically have to designate a primary care physician for regular check-ups and referrals. But you can also use out-of-network providers if you’re willing to pay more out of pocket; you’ll usually have a copayment and deductible as well.
This type of plan is versatile, and can be right for people who are willing to pay a bit more for extra flexibility.
|High-Deductible Health Plan (HDHP)||High-deductible plans cross categories. Some are PPO plans, while others may be EPO or HMO plans. This type of health insurance has a high deductible that you have to meet before your health insurance coverage takes effect. These plans can be right for people who want to save money with low monthly premiums and don’t plan to use their medical coverage extensively.
HDHPs are often paired with Health Savings Accounts (HSAs). If you contribute money to an HSA, you can buy an HSA-compatible health plan. Money contributed to an HSA can be saved on a pre-tax or tax-deductible basis to pay for qualifying medical expenses, including annual deductibles.
If you’re buying an individual health insurance plan, you’ll generally need to enroll during the open enrollment period, which usually happens towards the end of the calendar year. For example, if you want to buy health insurance for 2019, the open enrollment period is scheduled to run from November 1, 2018 until December 15, 2018.You may be able to get a major medical health insurance plan outside of the open enrollment period if you have a qualifying life event (QLE).If open enrollment has passed, and you don’t have a QLE (such as the birth of a child, divorce, etc.) then there are alternative products on eHealth.com like short-term health insurance. You may find that buying a product like short-term health insurance and pairing it with more alternative products can be a good form of coverage if a major medical plan is not an option. See plan details for important limitations.Where can I see these options? Visit eHealth.com to find an individual health insurance plan or family health insurance plan that suits your health-care needs and your personal budget. Based on the information you provide, you will be shown options that are available to you in your area.You can also speak to a licensed representative or use eHealth’s chat function if you have any questions about either individual health insurance plans or family health insurance plans.Don’t be intimidated about shopping for your individual health insurance plan or family health insurance plan! With access to free quotes and licensed representatives showing you quality plans, you’ll be able to find the right plan for yourself or your family in no time.