Advantages and Disadvantages of Individual and Group Health Insurance
Switching from group to individual health insurance is a change
many people are currently facing. There can be some big
differences between the two types of insurance and their cost.
Becoming familiar with some of those basic differences will help
you to know what to expect.
Group Health Insurance
Group health insurance is purchased by your employer from a
health insurance company. Everyone who is eligible can receive
coverage under the plan. Group health insurance is less costly
than individual health insurance, because you have the buying
power of the group. The insurance company bases the premium upon
a calculation of how much insurance the group as a whole will
use. However, if you are buying individual health insurance, the
calculation of your premium is not based on a group, it's based
on you alone. That is why individual health insurance can be so
expensive.
Individual Health Insurance
Individual health insurance is health insurance that you purchase
from an insurance company on your own, and not through an
employer. You can choose coverage for either yourself or your
self and your family, individual policies often provide less
coverage than group policies do. Under an individual plan, some
services such as substance abuse treatment may not be covered.
Another important difference between group and individual health
insurance is that with group insurance, the law requires the
insurance company to cover everyone who works for that employer.
With individual health insurance, companies are not required to
issue you a policy. This can be very alarming for people who have
pre-existing conditions. If you have recently lost your job, it
can be surprising to find out that even though you have been
covered under a group plan, there is no assurance that you will
be able to obtain individual health insurance coverage.
In some states, health insurance companies are allowed to issue
policies to people with pre-existing conditions, but they are
issued with an exclusionary rider. That means that any services
for the pre-existing condition are not covered. Each state has
its own laws overseeing how individual health insurance is
administered. Therefore, plans can very a great deal from state
to state. Plans can also vary from one insurance company to
another. Be sure to check around and compare quotes and plans
from several different companies before making a decision.
COBRA As An Option
One of the first options presented to people who have lost their
health insurance coverage is COBRA. COBRA stands for the
Consolidated Omnibus Budget Reconciliation Act and it allows you
to continue on your employer's health insurance plan for up to
18 months after losing your job. However, there are several
situations in which employees would not be eligible for COBRA
coverage such as, if the company employed less than 20 people and
went out of business, or if it dropped its group health insurance
or went into bankruptcy.
One of the drawbacks of COBRA is the expense. Under COBRA you
have to pay the entire amount of your health insurance coverage.
Whereas when you were employed, your employer paid a portion of
your benefits. One recent development that will be beneficial to
COBRA recipients is that after March 1, 2009 recipients will only
have to pay 35% of the cost of the monthly premium and the
federal government will pay the remainder for up to nine months.
If you have recently lost your group health insurance, switching
to individual health insurance will cause the cost of your health
insurance to increase. Understanding the different types of
insurance and how they work, will help you to prepare. If you
have pre-existing conditions and are concerned about finding
individual health insurance coverage, investigate COBRA and find
out if it is an option. Also, check with several different health
insurance companies and compare the costs before you make a
decision.
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Kevin Kielty lives in North Carolina and writes articles
on health insurance. If you are looking for rate quotes
on health insurance in North Carolina, visit BCBSNC, also
known as Blue Cross and Blue Shield of North Carolina
www.ncinsuranceplan.com
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