Q: What is the difference between individual and family health insurance?
Some insurance companies give a discount for enrolling multiple family members on the same health plan. Individual and family health plans have the same overall benefits.
Q: Can I add my spouse or children later?
Yes. The process of adding or removing family members is much easier in the individual health plan market than in the employer group market, since there are no open enrollment periods with most plans. As your needs change, you can add newborn children to you health plan, remove older children that are getting employer coverage, remove a spouse that is turning 65 are going onto Medicare, etc.
Q: How much does individual health insurance cost?
Monthly health insurance premiums can vary based upon a person’s age, gender, home zip code and tobacco use. Healthier people can join a medically underwritten health plan to save money without compromising benefits. These plans are not advertised on www.healthcare.gov. Monthly premiums start at $77 per month for individuals and $219 per month for families. Our experienced agents at DFW Direct Insurance can help you to shop for the best health plan at the lowest possible monthly cost.
Q: What deductible should I choose?
Most health plans have an annual deductible that a person must first pay before the insurance company starts covering most or all of the medical expenses. For healthy people who rarely need medical care, a higher deductible plan can provide a lower monthly premium. For individuals requiring more frequent medical care, a lower deductible plan at a higher monthly cost can reduce out-of-pocket deductible expenses.
Q: What is an out-of-pocket maximum?
The out-of-pocket maximum is most a person will pay before their health insurance plan covers 100% of remaining medical expenses in a plan year or calendar year. To satisfy the out-of-pocket maximum, most health plans require a person to pay their annual deducible, plus any remaining coinsurance.
Example: John has a health plan with a $3,000 annual deductible, and 80% coverage after the deductible. The max out-of-pocket on his plan is $4,000. If John has a surgery, he can expect to pay his $3,000 deductible. Then his health plan starts paying 80% of his medical expenses. So John is still paying 20% of the medical bills (called coinsurance). Once John’s 20% in coinsurance expense adds up to $1,000, he has met the out-of-pocket max, and all medical expenses are then covered at 100% by the insurance company for the remainder of the calendar year.
Q: Can I switch health insurance plans during the year?
Yes, all health plans in the private, or individual insurance market are month-to-month, with no cancellation fees.