Individual / Family Insurance
Often, individuals and families are not able to get insurance benefits through work because they are not eligible or it is not offered: working part-time and/or being self-employed two good examples. In these instances, individuals/families must turn to the “individual/family” insurance market to find an insurance plan.
Fortunately, in most cases, the same or similar coverages that are available to employees through their employer’s group insurance plan offerings are also available to individuals/families in the individual/family insurance market. Also, specific to medical or “health” insurance, due to the new “Affordable Care Act” (ACA), now many families may qualify for financial assistance in paying for their medical plans through premium/tax subsidies offered through the “Marketplace/Exchange”. In some instances, this assistance can be more than what an employer offers in the way of premium subsidies!
The same type of plan styles (HMO, PPO and HSA), are available on the individual/family market as is found in the group market. Of course, as with any medical plan you will want to choose a plan design that makes sense for you/your family and that is affordable:
- HMO – A more limited network of providers, which you must use (except in an emergency) in order to receive benefits. This plan often provides a high level of benefits, particularly for “wellness/preventative” care as well as physician office based care. Due to the limited network of providers, the cost of these plans is usually lower than for a comparable PPO plan. Benefit choices include higher and lower deductible amounts and plans with “office visit co-pays”.
- PPO – The most common plan design today, provides for lower “out-of-pocket” costs if you use “Preferred Providers” within their provider network, but you may use any provider of your choice. As with HMOs, these plans often provide a high level of benefits, particularly for “wellness/preventative” care as well as physician office based care. Benefit choices include higher and lower deductible amounts and plans with “office visit co-pays”.
- HSA - Young, healthy individuals who don’t see themselves using medical services often go with HSA (Healthcare Savings Account) plans to keep their premiums low. The benefits under these plans are more limited, but this plan design also allows for covered individuals to “save” for future medical expenses on a “tax-deductible/deferred” basis.
Individual dental plans are not nearly as common as medical plans, with only a limited number of carriers offering plans. However, this coverage is just as highly desired and necessary for individuals/families as it is for employer groups - with several carriers offering high quality plans at affordable prices.
The availability of individual/family vision plans in somewhat limited, however there are still several individual plans on the market that provide good benefits for a reasonable cost. As we become ever more dependent on computers, tablets, smartphones, etc., we are also finding that more and more people are in need of vision hardware to help them see clearly.
Disability (Income Protection)
Disability insurance is one of the most important plans for protecting your way of life - however, with only 21% of working Americans actively enrolled, it is also one of the most overlooked. Most people tend to think in absolute terms; life or death, sickness or good health, etc., and most people plan for these with the purchase of medical/health and life insurance. But what about if you become sick or disabled and cannot work: how will you pay your bills (rent. utilities, food) if no (or less) money is coming in? Disability insurance provides the protection you need by ensuring an income will continue in the event of an accident or illness occurring which prevents you for working.
Long Term Care
Beyond the ability to work and earn an income, some people’s disability (due to accident, illness or just age) becomes so severe that they need help with even the most basic of daily activities, such as: eating, dressing, etc. Long-term Care Insurance provides help in instances where the insured can no longer help themselves, and do not have family members available to help them. This type of care can occur in different settings, including: in-home assistance, assisted living and skilled nursing care facilities. While this is often thought of as insurance for “old people”, statistics show that an increasing number of young and middle aged people are in need of this coverage.