Having peace of mind starts by getting a health insurance plan. While the reasons for having or not having insurance vary from person to person, you want to be prepared in the event a health problem may arise.
Let’s take Manon’s example. She’s a Canadian citizen who got a job in Tampa. Since her H1-B visa hadn’t been finalized yet, her employer couldn’t offer her group insurance. Although her boss suggested she get individual health insurance, she declined, thinking it wouldn’t take long for her immigration status to change. Unfortunately, she came in contact with Caladium plants while on a camping trip, which she had no idea they’re poisonous. She immediately had teary eyes, swollen mouth and vomiting. Her reaction, which turned out to be poisoning, sent her to the emergency room where she had to pay high medical expenses.
Do you know anyone who has suffered a similar fate? Have you heard similar stories? Murphy’s Law usually happens when you least expect it, and yes, that includes illnesses and accidents.
But, now you may be asking yourself, “what type of insurance should I get?” Indeed, there’s a plethora of plans and insurance companies to choose from. However, on this page we’ll discuss individual health insurance.
According to the National Association of Health Underwriters which represents more than 100,000 licensed health insurance agents, brokers, general agents, consultants and benefit professionals through more than 200 chapters across America, the definition of individual health insurance is coverage that an individual purchases for himself and/or his family. Premium rates both on and off of the marketplace are determined by the age of each individual who will be covered by a plan. Other factors that affect the premium for coverage include where a person lives and the level of plan (metal tier) that they select.
These tiers are based on the percentage the plan pays of the average overall cost of providing essential health benefits to members:
- Platinum plans are the most generous and more expensive. These are designed to pay as much as 90% of medical expenses
- Gold plans are designed to pay 80% of medical expenses
- Silver plans are expected to pay 70% of medical expenses
- Bronze plans are expected to pay 60% of medical expenses.
It’s important to note that the metal tiers reflect what the plans will pay on average. These percentages are not the same as coinsurance, which calls for an individual to pay a specific percentage of the cost of a specific service.
Individuals may be eligible for government subsidies to help pay for premiums. Subsidies are available only for coverage purchased through the exchange. Subsidies are calculated based on the modified adjusted gross income for the year and the household size. Subsides may be available to individuals with incomes between 100% of the Federal Poverty Level (FPL) and 400% of the FPL. More information on qualifying for premium assistance can be found at https://www.healthcare.gov/will-i-qualify-to-save-on-monthly-premiums/.
Individuals may also qualify for savings on out-of-pocket costs when they obtain medical care. These savings are called “cost-sharing reductions.” Cost-sharing reductions reduce the amount an individual pays for out-of-pocket costs such as deductibles, coinsurance and copayment. They are available for Silver plans purchased through the exchange for individuals with incomes no higher than 250% of the FPL.
Some of the reasons people shop for individual health insurance are:
1) You are self-employed, work part time, or full time for a small business that doesn’t provide health insurance coverage.
2) Your benefits through your employer don’t provide customized health insurance coverage to fit your individual needs.
3) Due to increasing Florida health insurance rates, businesses are forced to pay less towards an employee’s health insurance, forcing you to find your own insurance.
No matter your age, your lifestyle, or your employment status, at McKnight & McKnight Insurance Solutions, we will help guide you toward the individual health insurance plan you need and fit your unique life stage.
Our agents have the insurance knowledge and expertise to match you with the coverage that fits your needs. With the health insurance market changing frequently, we are always on the lookout for quality, service-oriented insurance companies for our clients.