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Private individual health insurance is a viable option if you don’t have employer-sponsored healthcare or can’t afford a plan through the Affordable Care Act Marketplace. 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.
Quick Look: Best Individual Health Insurance Providers
Table of contents [Show]
- Quick Look: Best Individual Health Insurance Providers
- Best Individual Health Insurance
- 1. Cigna
- 2. Aetna
- 3. UnitedHealthcare
- 4. Blue Cross Blue Shield
- 5. Kaiser Permanente
- What is Individual Health Insurance?
- Difference Between Individual and Family Health Insurance
- How Much Does an Individual Health Insurance Plan Cost?
- Types of Individual Insurance Plans
- Get the Best Individual Health Insurance Coverage
- Frequently Asked Questions
Best Individual Health Insurance
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:
Cigna was ranked as a top health insurance provider in the J.D. Power 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.
Cigna Health Insurance offers low-cost private health insurance and Medicare Advantage and Supplement Plans for families and individuals. Founded in 1982 and based in Bloomfield, Connecticut, the company offers a wide array of health insurance plans including three Bronze plans, four Silver and one Gold. All Cigna plans are EPO plans, meaning they are all in-network. Free telehealth visits come with every plan and are available to customers 24/7.
The four-metal tier coverage plans include:
- Expanded bronze
Individual and family Cigna private insurance plans are all available on the Marketplace and through the Cigna website, as well as with licensed agents in each state. Because they are sold through the Marketplace, they can only be purchased during your state’s open enrollment period. Special enrollment periods apply for special circumstances.
- Easy access to benefits
- Pharmacy programs
- Savings and spending accounts such as HSA and FSA
- Supplemental plans
- Home delivery for prescriptions
- Health management mobile apps
- Easy ID card replacement
- Potentially high deductibles
- Not available in all 50 states
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.
In the past, Aetna health insurance plans were available on Affordable Care Act (ACA) Marketplaces across the country. Though Aetna no longer offers ACA-compliant plans, the company continues to make healthcare more affordable through Medicare Advantage Part D coverage and dental insurance plans.
Aetna’s Medicare options extend to most parts of the country, and premiums for Advantage plans begin at $0 a month. Part D coverage, which helps pay for prescription drugs, begins at about $7 a month in most states. Additionally, Aetna offers dental insurance and dental discount plan options that anyone who doesn’t have dental coverage through their employer can take advantage of. In addition, Aetna also offers a number of additional benefits not seen with other coverage providers, including discounts on prescription drugs and rewards for meeting health goals.
- Member support
- Offers multiple mobile app offerings to reward you for reaching fitness goals
- Dental discount plans may include coverage for prescription drugs
- Medicare Advantage plans available with no monthly premiums
- Vision insurance only available when purchased with a dental plan
- ACA-compliant health insurance no longer available
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.
UnitedHealthcare is an insurance company that is dedicated to making the health care system work better for everyone. Its plans can serve customers of all ages, starting in childhood and continuing all the way through the retirement years. The company partners with more than 1.3 million health care professionals and over 6,500 hospitals to give customers the freedom to access healthcare wherever they are. This insurance provider has a strong financial standing and good ratings, making it a reliable option for just about anybody.
- People who want flexibility in their health care coverage
- People who want supplemental insurance coverage
- People who qualify for both Medicare and Medicaid
- Offers a wide variety of plans
- Strong financial and customer service ratings
- ACA and non ACA plans available
- Not all plans ACA-compliant
- The website can make it difficult to get a quote
4. 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.
Blue Cross Blue Shield consists of 35 separate companies that provide health insurance for roughly one-third of Americans. The company serves all 50 states, Washington D.C., Puerto Rico, and many international areas.
While you look into the BCBS affiliates near you, understand what health plans are available as well as the health insurance cost. It offers extensive coverage that gives just about every American the opportunity to purchase a BCBS-affiliated health plan. However, be sure to read up on the company because the premiums and deductibles may not suit you and your circumstances.
- Desire for a new doctor with plenty of options
- No cap on annual maximum limits
- Comprehensive coverage with exclusive discounts and partnerships
- Coverage in all 50 states and outside the country
- Covers both generic and brand-name drugs
- Wide network of doctors, hospitals and specialists
- Plans offered through regional companies, meaning you must look to your regional company for specific policies
- Main customer service helpline may be difficult to reach
5. 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.
Kaiser Permanente is a not-for-profit health plan. Kaiser Permanente offers both health insurance and health care, which has resulted in excellent reviews from customers and rating organizations. Kaiser Permanente does have limited service areas, and you typically need to stay in-network for services unless you’re experiencing an emergency.
- People in Kaiser Permanente service areas
- People who don’t mind managed care
- People who like to manage their care online
- Many services available in one location
- Ability to make appointments online or using an app
- Good customer service
- Limited service area
- Need to stay in the Kaiser Permanente network for most services
What is Individual Health Insurance?
Individual healthcare plans are those you purchase on your own. It can actually be a healthcareplan for just you, the individual, or you and your family. The thing that distinguishes it is that isn’t part of a group plan, like one offered by your employer.
Difference Between Individual and Family Health Insurance
Health insurance for individuals is 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 an Individual Health Insurance Plan 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 independent 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.
Get the Best Individual Health Insurance Coverage
Wondering how to get personal 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
Is small business health insurance cheaper than individual?
Usually, group health insurance is cheaper than individual coverage, even if your group coverage is provided by a small business.
Can individuals deduct health insurance premiums?
Yes, you can generally deduct monthly health insurance premiums are a medical expense. According to federal guidelines, you can deduct any out-of-pocket medical expenses from your taxes.