Best Individual Health Insurance

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Contributor, Benzinga
February 5, 2024

Jump straight to it: The best way to get individual health insurance is with Cigna.

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 health 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

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: 

1. Best for Wellness Programs: Cigna 

Cigna was ranked as a top health insurance provider in the J.D. Power Customer Satisfaction Study. It offers individual health plan options 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. 

Pros

  • Large network of healthcare providers
  • Offers a variety of insurance plans to choose from
  • Offers 24/7 customer support and online access to manage claims
  • Provides access to a range of additional health and wellness resources

Cons

  • Not available in all states
  • Potentially higher premiums and deductibles
  • Limited coverage for certain medications and treatments

2. Best for Health Coaching: 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. 

Pros

  • Offers various coverage options and plans to meet individual needs
  • Provides access to wellness programs and resources
  • Offers 24/7 customer support and virtual care

Cons

  • Premiums can be expensive, especially for comprehensive coverage
  • Certain services or treatments may not be fully covered or require pre-authorization
  • Certain plans have limited coverage areas

3. Best for Online Appointments: 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. 

Pros

  • Trusted and reputable health insurer
  • Provides access to specialized care and services
  • Provides 24/7 support and virtual services

Cons

  • Limited plan options in some regions or states
  • Relatively higher premiums for individuals

4. Best for Employee-Sponsored Insurance: Blue Cross Blue Shield 

Blue Cross Blue Shield is a top provider of individual health insurance plans nationwide. BCBS 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. 

Pros

  • Available nationwide and internationally
  • Provides an extensive provider network
  • Offers a variety of health plan options

Cons

  • High deductibles on some plans
  • Customer service may vary depending on the region or state

5. Best for Local Office Service: 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. 

Pros

  • Provides a wide range of health plan types for all budgets
  • Offers free virtual care on most plans
  • High customer satisfaction rating

Cons

  • Not available in all states
  • Most plans are HMO types

What is Individual Health Insurance?

Individual healthcare plans are those you purchase on your own. It can actually be a healthcare plan for just you, the individual, or you and your family. The thing that distinguishes it is that it isn't part of a group plan, like one offered by your employer. These policies can come from a range of sources. You should also be aware that there are plans you can purchase from associations or organizations that cover your costs but don’t operate like insurance carriers.

Because there is such a wide range of options on the market, you should review everything out there and not just spend less. Pay a little more to get the health coverage you need, but don’t overinsure yourself and lose money in the process.

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 plans or group plans are different.

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. 

Health Maintenance Organization (HMO) Plans

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. 

Preferred Provider Organization (PPO) Plans

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. 

Exclusive Provider Organization (EPO) Plans

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. 

Point of Service (POS) Plans

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

Q

Is small business health insurance cheaper than individual?

A

Usually, group health insurance is cheaper than individual coverage, even if your group coverage is provided by a small business.

Q

Can individuals deduct health insurance premiums?

A

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.

Q

Can employer pay for individual health insurance?

A

Yes, an employer can pay for individual health insurance for their employees. This is commonly known as an employer-sponsored health plan. It is a benefit provided by the employer to help cover the cost of health insurance premiums for individual employees. However, some specific details and policies surrounding employer-sponsored health insurance can vary depending on the country and local laws.

About Janet Hunt, Insurance Agent

Janet has been working in, and writing about, the insurance industry for over 20 years.