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Some employers
offer only one health insurance plan. Some offer a choice
of plans: a
fee-for-service
plan, a health maintenance organization (HMO),
or a preferred provider organization (PPO),
for example. Employers with 25 or more workers are required
by Federal law to offer employees the chance to enroll in
an HMO.
What happens
if you or your family member leaves the job? You will lose
your employer-supported group coverage. It may be possible
to keep the same policy, but you will have to pay for it yourself.
This will certainly cost you more than group health insurance
coverage for the same, or less, protection. A Federal law
makes it possible for most people to continue their group
health insurance coverage for a period of time. Called COBRA
(for the Consolidated Omnibus Budget Reconciliation Act of
1985), the law requires that if you work for a business of
20 or more employees and leave your job or are laid off, you
can continue to get health insurance coverage for at least
18 months. You will be charged a higher premium than when
you were working.
You also
will be able to get health insurance under COBRA if your spouse
was covered but now you are widowed or divorced. If you were
covered under your parents' group plan while you were in school,
you can also continue in the plan for up to 18 months under
COBRA until you find a job that offers you your own health
insurance.
Not all
employers offer health insurance. You might find this to be
the case with your job, especially if you work for a small
business or work part-time. If your employer does not offer
group health insurance, you might be able to get group insurance
through membership in a labor union, professional association,
club, or other organization.
Individual
Health Insurance Plans
If your
employer does not offer group health insurance, or if the
insurance offered is very limited, you can buy an individual
health insurance policy. You can get fee-for-service,
HMO,
or PPO
protection. But you should
compare your options and shop carefully because insurance
coverage and costs vary from company to company. Individual
health insurance plans may not offer benefits as broad as
those in group health insurance plans.
If you
get a non-cancelable health insurance policy (also called
a guaranteed renewable policy), then you will receive individual
health insurance under that policy as long as you keep paying
the monthly premium. The insurance company can raise the cost,
but cannot cancel your coverage. Many companies now offer
a conditionally renewable policy. This means that the insurance
company can cancel all policies like yours, but not only yours.
This protects you from being singled out. But it does not
protect you from losing health insurance coverage.
Some
tips when shopping for individual health insurance:
- Shop
carefully. Individual health insurance policies differ
widely in coverage and cost. Contact different insurance
companies, or ask your agent to show you policies from several
insurers so you can compare them.
- Make
sure the individual health insurance policy protects you
from large medical costs. Read and understand the policy.
Make sure it provides the kind of coverage that is right
for you. You do not want unpleasant surprises when you are
sick or in the hospital.
- Check
to see that the health insurance policy states: the
date that the policy will begin paying (some have a waiting
period before coverage begins), and what is covered or excluded
from coverage.
- Make
sure there is a "free look" clause. Most companies give
you at least 10 days to look over your policy after you
receive it. If you decide it is not for you, you can return
it and have your premium refunded.
- Beware
of single disease insurance policies. There are some
polices that offer protection for only one disease, such
as cancer. If you already have health insurance, your regular
plan probably already provides all the coverage you need.
Check to see what protection you have before buying any
more insurance.
Before
you buy any health insurance policy, make sure you know what
it will pay for... and what it will not. To find out about
individual health insurance plans, you can call health insurance
companies, HMOs, and PPOs in your community, or speak to the
agent who handles your car or house insurance. You can also
find
and compare plans online by clicking here.
 
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