You recently took a job with an employer that doesn’t offer healthcare coverage. Or maybe you’re self-employed and are seeking a plan that won’t break the bank when you receive medical care.
Private individual health insurance is a viable option. But with so many providers to choose from, how do you know which is best? How much will coverage cost? And how do HMO, PPO, EPO and POS plans differ?
These questions, alone, are enough to make your head spin. But don’t fret. Purchasing coverage is not as hard as it may seem, and we’re here to help you find and select a plan that meets your needs.
Read on to learn more about how individual health insurance plans work, what you can expect to pay and plan types. We’ve also included a list of top providers to assist you with your search.
Get Individual Health Insurance
Tip: compare 2-3 companies
Best Individual Health Insurance:
- Best Customer Service: Cigna
- Best for Health and Wellness Programs: Aetna
- Best for Virtual Care: UnitedHealthcare
- Best for Provider Choice: Blue Cross Blue Shield
- Best for Affordable Coverage: Kaiser Permanente
Individual vs. Family Health Insurance
Individual health insurance plans are available for purchase through your state’s health insurance marketplace or directly from the insurance company.
But how do the plans differ, and how do you know which is best? Below are quick descriptions to help you distinguish between them:
- Individual health insurance: A plan that covers one member, ideal for single individuals
- Family health insurance: A plan that covers multiple members and optimal if there are family members who also need health insurance coverage
How Much Does Individual Health Insurance Cost?
On average, the monthly health insurance premiums for individual plans is $440. When retrieving a quote, be sure to specify that you’re seeking an individual plan as premiums for family coverage are steeper.
You could pay far more or less as premiums are determined by several factors. Health insurance providers consider your age, location and coverages. You may also be asked about tobacco use, which can result in significantly higher premiums.
Also, consider out-of-pocket costs like deductibles, copayments and coinsurance. These expenses are paid outside of your monthly premiums and can add up quickly.
Your deductible is the amount that you’re responsible for before your policy starts to work for you. So, if your deductible is $2,000, you must pay this amount out of pocket for healthcare services before any additional covered services will be taken care of by your insurance provider.
Copayments are set percentages attached to services covered under your plan. Your policy may call for a copay of $20 for routine doctor visits and $40 for appointments with specialists. And coinsurance is the percentage of expenses you’re responsible for when certain healthcare services are rendered. For example, if you’ve met your deductible and coinsurance is 20 percent on surgical services, you’ll pay $200 out-of-pocket on a $1,000 medical bill.
Types of Individual Insurance Plans
There are several variations of individual health insurance plans you should be aware of.
HMO: Health maintenance organization (HMO) plans are more affordable for consumers, and you may be able to receive preventive services without meeting your deductible. But with lower costs come drawbacks. You are obligated to choose in-network providers for services to be covered. These doctors, specialists and facilities are contracted with your provider to serve you at a reduced rate. Also, you won’t have the luxury of seeing specialists without a referral from your primary care physician. And if you decide to venture outside of the network, you may be on the hook for 100% of the costs.
PPO: Preferred provider organization (PPO) plans allow you to use both in-network and out-of-network providers. While the latter will cause you to incur increased out-of-pocket costs, a percentage of the services may be covered under your plan. Unlike HMO plans, you will not be required to choose a PCP provider, but you may be required to meet a deductible before coverage kicks in.
EPO: Exclusive provider organization (EPO) plans only offer in-network benefits. This means you are only permitted to use select providers and hospitals to be eligible for coverage. If you receive care outside the network, you will be responsible for 100% of the costs incurred for services.
POS: Point of service (POS) plans merge the best of HMO and PPO plans. Similar to a PPO plan, it is necessary to choose a PCP. But preventive healthcare services may be covered without meeting your deductible. And you’ll be allowed to see out-of-network providers if you wish. However, a significant drawback is that they may assess a bill for 100% of the costs. And it’ll be your responsibility to seek reimbursement from the insurance provider for the percentage of services that are covered. If you’ve already met your deductible, you will still be responsible for submitting your own claims from processing.
5 Best Individual Health Insurance Companies
The best health insurance companies offer exceptional customer service, seamless claims processing, great provider choices, flexible care options and affordable premiums. They are also reputable, exude financial strength and have a proven track record of success.
Here are Benzinga’s top picks for providers with the best individual coverage:
1. Best for Customer Service: Cigna
Cigna was ranked as a top health insurance provider in the J.D. Power 2019 Customer Satisfaction Study. It offers individual plans for every budget. And its provider network is vast, so you’ll receive phenomenal service in all 10 states they serve.
You’ll also have access to its health and wellness knowledge center. So you won’t have to spend hours sifting through tons of websites to find the information you’re looking for. You can also call Cigna’s customer service hotline 24/7 to get answers to your most pressing questions.
2. Best for Health and Wellness Programs: Aetna
Become the best version of yourself by staying on top of your health. Aetna makes it easy to do just that with its suite of health and wellness programs. With over 70 programs to choose from, Aetna Health Connections has the tools to help you lead a healthy lifestyle.
Aetna also offers an online program, Simple Steps to a Healthier Life, which screens you for potential risk factors and creates tailored solutions based on the findings. There are also personal health and wellness coaching, mindfulness programs and so much more.
As with any policy, health and wellness program availability varies by plan. Inquire with a customer service agent to learn more.
3. Best for Virtual Care: UnitedHealthcare
UnitedHealthcare is another leading provider of individual health insurance plans. It claimed the top spot in its sector on Fortune’s World’s Most Admired Companies list for 9 consecutive years.
As a UnitedHealthcare subscriber, you can take advantage of virtual visits without incurring any added costs. And no need to leave the comforts of your home. You can schedule appointments through your primary care provider and be seen by a medical professional via your smartphone, tablet or computer. Even better, doctors are standing by 24/7 to assist you with your healthcare needs, so you can receive care any time of the day or night.
4. Best for Provider Choice: Blue Cross Blue Shield
Blue Cross Blue Shield is a top provider of individual health insurance plans nationwide. It has been around since 1929 and insures 1 in 3 Americans.
In 2019, several commercial plans from Blue Cross Blue Shield were honored by J.D. Power for provider choice and customer satisfaction. It also ranked highly for benefits and coverage.
Beyond the high-quality benefits it offers policyholders, its vast provider network helps it stand out among the competition. You will find providers for a range of medical services in every state around the nation.
5. Best for Affordable Coverage: Kaiser Permanente
No need to spend a fortune to receive quality medical care. Kaiser Permanente offers individual health insurance plans for all budgets. Subscribers enjoy low premiums, reasonable deductibles and a vast provider network at a fraction of the cost you’d pay with other providers.
Kaiser Permanente stands firm on the belief that every individual should have adequate access to healthcare. It offers subsidized health care coverage through its Charitable Health Coverage programs to serve low-income individuals. Those who struggle to find affordable health insurance or do not have access to reasonable healthcare through their employers may also qualify.
Get the Best Individual Health Insurance Coverage
Wondering how to get health insurance from a reputable provider that’s affordable and meets your needs? All you have to do is enter your ZIP code to receive a customized offer. It only takes a few minutes of your time to inquire, and there’s no obligation to purchase coverage if the quoted offer isn’t a good fit. Shop around for different providers until you find an individual health insurance plan that’s perfect for you.
Frequently Asked Questions
1) Q: Is health insurance required?
The federal mandate that required health insurance has been lifted but some states have enacted state-level mandates that require residents to have health insurance. Even where not required, health insurance can protect your family against catastrophic healthcare costs and help make routine medical expenses more predictable. Get your most affordable quote through our top providers today.
2) Q: What does health insurance cover?
Most health insurance plans provide the 10 essential health benefits that were part of Obamacare requirements. Coverages include preventative and wellness services, prescription drug coverage, emergency services, ambulatory services, lab services, pediatric services, and more. Many plans cover a wider range of healthcare expenses but may cost more than basic plans or may have higher out-of-pocket costs for some services.Get a custom health insurance quote to cover you and your family today.
3) Q: How can I save money on health insurance?
For healthcare plans that comply with the Affordable Care Act, only a handful of rating factors affect your premium. These include age and location, at least one of which can’t be changed. Smokers will pay more in most cases and your choice of plan level can affect premiums as well. Choosing a high deductible health insurance plan can reduce the cost of premiums. These plans can be combined with a health savings account to take advantage of tax-free savings for healthcare expenses. Get the cheapest health insurance premium from top providers.