Many people get their health insurance through their employers. But if your employer doesn’t offer health insurance, or if you’re unemployed or self-employed, you'll still need a health plan. That’s where individual insurance comes in. You shop, purchase, enroll, and pay for it yourself. Despite its name, you can purchase individual insurance for your family, not just for yourself.
There are three major factors to consider when shopping for a health plan:
Premera can help you decide which plan is best for you, and learn whether you qualify for financial help with your health plan costs. We can also help you buy a plan. Call us at 800-722-1471 with any questions.
You’ve probably heard the terms bronze, silver, and gold plans. These terms refer to how much you’ll pay. They don’t refer to the benefits in a plan and they don’t rate the quality of the medical care you’ll receive.
There are three important kinds of costs to consider:
Premiums. Up-front monthly costs that you pay regardless of whether you use any healthcare services. This is similar to the premium you pay for car or home insurance, regardless if you ever have an accident or file a claim.
Cost shares or out-of-pocket costs. This is what you pay if you see a doctor or get other medical care. You pay only a share of the cost, and your health plan pays the rest. Common cost shares are deductibles, copays, and coinsurance.
Out-of-pocket maximum. The maximum amount you could have to pay in a year for covered services from in-network providers.
For more about important insurance terms, see Health Plan Terms to Know.
What’s best for you?
Which plan is best for you depends on several things, but primarily on whether you have some health or medical problems and expect to need a lot of medical care and services during the year, or whether you are in excellent health and need a health plan just in case something happens.
Keep in mind, all plan levels—bronze, silver, and gold—cover most preventive care, in full, with little or no out-of-pocket cost to you.
Another term you’ll see in some plan names is HSA, which stands for health savings account. These plans generally have high deductibles, meaning you’ll pay that amount for medical costs before your health plan’s coverage kicks in. These plans may have special tax advantages, and allow you to set up a special bank account for medical expenses. Because these plans have high deductibles, they generally have lower premiums. You should make sure you understand how these plans work before choosing them.
Other factors that affect the cost of plans
Call us at 800-722-1471 with any questions about your health plan.
Open enrollment for 2015 individual plans ended February 15. But you may be able to enroll or change plans now if you experience a qualifying life event.