What Health Insurance Coverage Do You Need?

Once you have familiarized yourself with the basics of low cost health insurance and it’s terminology you should define exactly what you are looking for with respect to low cost healthcare coverage.  Keep in mind that the more you expect or want the health insurance company to pay if something happens, the more they will charge you every month in health insurance premiums.

Defining your wants is easy and most people want the same thing.  Comprehensive and affordable low cost health insurance with low deductibles, low co-payments, and to have the ability to go to any doctor whenever they want.  In most cases, people are trying to duplicate the group health insurance coverage they had with their employers, or looking for a plan to replace their small group health insurance coverage because they feel it is too expensive.  Either way it is important to know what the differences between group and individual health insurance are.

The biggest difference between family or individual health insurance and group or employer sponsored health insurance is that with a group health plan in Florida, you have guaranteed insurability.  Most state laws require that the employer pay at least a portion of the employee’s premium.  There is a minimum, but many employers choose to pay more, and in some cases pay all of the employees premium.  This is a great deal for the employee, but unless the employer is also subsidizing the families premium (many employers do not), it can get expensive.  If this is the case you should look for alternative health insurance for the rest of the family and put yourself on your employers health plan.

Ever hear anyone say, “I just got COBRA health insurance and it is really expensive” or "I am not going to take COBRA because it is too expensive".  Well, that is what your group health insurance plan costs when your employer isn’t paying for it.  The difference bewtween what your were paying and your COBRA premium is your employer was paying on your behalf. The lesson here is that if you, as an employee, have a group health insurance plan available, most of the time that is the best choice for you.  What you have to do is compare the cost of adding your family to the company health plan versus the cost of putting them on an individual health insurance plan.  Doing this could save you several hundred dollars in premium per year.  In some cases you could save thousands of dollars in annual health insurance premiums. it is definitely worth the time to investigate this.

Group health insurance policies are usually guaranteed issue.  This means that you cannot be declined for health reasons or pre-existing conditions.  The problem is that many people don’t have this option available or don’t know that this is an option.  For those that do this is almost always the best choice as it provides comprehensive health coverage at reduced cost (employer pays part or all).

If you are coming off a group health insurance plan and you are looking to keep the same levels of healthcare coverage, it will be expensive.  Keep in mind that now you are paying for it all.  You have to ask yourself how often you used that health insurance and how often do you think you are going use it.  What do you want the health insurance to cover and what are you willing to absorb.

If you are not healthy (or have a pre-existing condition) the new health insurance company may exclude it, rate you up, or you might even get declined.  If you have any pre-existing conditions they may or may not affect your insurability, the best way to find out what to expect is to speak with an independent health agent.  They can do a pre-screen for you and at least be able to give you an idea of what to expect from underwriting and tell you what steps you should take. 

By all means, when you are offered COBRA coverage TAKE IT!  If you don’t, you will lose your HIPAA eligibility.  If you follow the rules regarding HIPAA, you will be guaranteed the ability to get individual health insurance.  Caution: if you get short term medical insurance you may lose your HIPAA eligibility.

Defining your health insurance needs is also relatively easy.  You need to have comprehensive health insurance coverage to cover those medical expenses that you would otherwise not be able to afford.  Part III, Understanding the differences between health insurance plans, will help you identify the benefits you are interested in and help you determine the costs.