#private health insurance
Private Health Insurance May Save You Money
By Michael Bihari, MD. Health Insurance Expert
Updated December 15, 2014.
Buying private health insurance may save you money.
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According to the Kaiser Family Foundation, the average American worker contributes $779 for an individual health plan and $3515 for a family health plan. Since this is an average, some employees may be paying much more.
Shop Online for a Better Health Insurance Premium
Shop around online and see if you can find a private insurance policy that provides you with the coverage you need but is less expensive than the premium you pay at work.
This organization provides an interactive Health Insurance Eligibility Quiz to help you find affordable health insurance options in your state. After answering five questions about your household, the site provides you with a customized profile that includes the public and private health plans in your state for which family members in your household may qualify.
Another place to seek information for health plan options in your area is ehealthinsurance. This online company provides information and access to 1000s of health insurance plans and is licensed in all 50 states and the District of Columbia .
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Even if you don t buy insurance through them, ehealthinsurance is a good place to search for a health plan and get a sense of how many plans are available in your state and how much they cost.
How Buying a Private Plan May Help
Nearly 30% of people who work in small companies that offer health care coverage pay more than half of their monthly health insurance premium as a payroll deduction.
Since the average premium for a family is more than $13,000, many employees could be paying more than $6,500 each year. Some of these employees may do better buying their own insurance. For example:
Doug Jones works for a small company that offers a PPO health insurance plan (with a yearly deductible of $1500) for employees and their family. Because of the recent down turn in the economy, Doug s company increased his share of the monthly premium to 60%, which costs Doug almost $700 each month.
Doug s wife works part time as a librarian and has no health insurance benefit. The Joneses have two children ages 7 and 10. All four family members are in good health and have a healthy lifestyle.
If Doug s company was located in the northern suburbs of New York City, his health plan choices would be limited and a comparable plan to the one he has at work would cost him more than $1,000 a month – not a good option for Doug!
If Doug s company was located in northern Ohio, his selection of affordable health plans would be considerably better with more than 100 health plan options. Depending on how much of a deductible, copayment, or coinsurance he is willing to pay, he can find a plan for himself and his family for considerably less than what he pays at work.
Planning on Switching? Be Careful!
Even if it is less expensive, dropping your job-based coverage and switching to a private plan that you buy may not be the best option for you. Health insurance you get from your employer has some very important protections that may not be available (depending on the state you live in) if you buy private insurance.
- Guaranteed issue – If your employer offers health insurance, you (along with all employees) must be accepted for coverage, regardless of your health status.
- Guaranteed renewability – Your employer (or health plan) cannot cancel your insurance if you become sick.
- Portability – If you had health insurance (either private or from another employer) before enrolling in your current job-based coverage. your new health insurer must reduce any preexisting condition waiting times by the amount of time that you were covered on your previous plan.
For example, if your new health plan has a 6-month waiting period before covering your treatment of high blood pressure and you had health insurance coverage for the past 12 months, you would be fully covered for your high blood pressure when you start your new plan.
Health Reform Changes
The Patient Protection and Affordable Care Act signed into law in March 2010 addresses access to health insurance coverage and assures that all Americans who need coverage will be able to get health insurance. It is not clear how the legislation will impact the cost of health insurance, especially premiums and out-of-pocket expenses. It is likely the costs will continue to increase for the foreseeable future.
Starting in 2014, you will be able to purchase health insurance in a health insurance exchange that will be available in all states. At that time, health insurance companies will not be allowed to impose any pre-existing condition limitations. However, until 2014, the recommendations above will continue to be valid.
Understand Your Options
You also need to make sure that you fully understand the benefits and limitations of the private plan compared to your employer-based plan. Are the benefits the same? If the private health insurance is a managed care plan (such as a PPO or HMO ), are your doctors in the network?
If you apply for private health insurance, do not cancel any health insurance coverage you currently have until you receive an approval letter and insurance policy, or contract from the health plan you selected. ,
Before you make any commitment, carefully review the new insurance policy.