Individual Health Insurance vs. Group Health Insurance
A health insurance plan is a legal agreement entered into by an insurance company and an individual or an organization. Once signed, the insurance company is legally bound to pay a specified amount of medical expenses arising during the contract period in exchange for paying a pre-determined monthly premium. The medical services covered by your insurance provider purely depend on the premium amount and the type of Health Insurance policy that you or your company chooses.
Before you decide on the exact type of health insurance plan you or your organization requires, it is important to know the different coverage options in market. It is good to know what you are eligible for as well as the various benefits that health insurance plans offer. Understanding your options allows you or your company to select the very best insurance plan for the money.
Below is a short overview illustrating the distinction between individual and group health insurance:
Individual Health Insurance: Individual health insurance plans are designed for unemployed or self-employed people who pay a premium directly to the medical insurance company in exchange for health insurance coverage. Individual health insurance plans are generally more expensive than group health insurance. Because the cost involved in medical expenses is very high, the narrow spread of risk makes the risk factor of the insurance company higher and passes that higher risk on to the individual in the form of a higher premium. The individual who purchases health insurance also needs to go through certain medical tests (as per the insurance company) in order to qualify for the health insurance plan. Under individual health insurance you can also cover your spouse or children under the same plan.
In relation with the high cost of individual health insurance, the insurance company usually lets you choose an appropriate Health Insurance plan that meets your needs, adjusting for your budget. You can also renew your individual health insurance plan annually and at that time you have the opportunity to make modifications to the plan as needed.
Group Health Insurance: Group health insurance plans are designed for a large number of people associated with a single organization or company. Group health insurance is usually purchased by the company or organization on behalf of employees as an added benefit for the employee. Since the insurance premium amount is usually paid by the company or organization, the vast majority of individuals get their insurance through their employer.
With group health insurance, the insurance company covers everyone under a single group plan. This distributes the cost and risk across the entire organization while also reducing the risk for the insurance carrier. As a result, group plans generally do not require a medical exam to qualify and previous medical conditions are covered.
The potential downside to group medical plans is the fact that the company or organization providing the plan selects the amount of coverage to be offered their employees, the plan options and deductable amounts. These options, though available to individuals buying plans on their own, are not available to employees.
In the end, every individual should have a health insurance plan. You might be in good health or rarely visit a doctor but nobody can predict what is going to happen tomorrow. One illness or even an accident can result in high medical expense which can significantly impact your financial situation. Although the cost of medical coverage is growing every year, the security and assurance you gain as a result of paying the increasingly high premiums far outweighs the cost.
Mark Anderson is a serial entrepreneur and having started, operated and sold several businesses both as a solo-entrepreneur as well as building one of his small businesses into a 35 person organization. Through this process Mark has become an expert in the field of medical health insurance for individuals and small business.
You can read more about Mark and his experiences with buying individual and group health insurance on his blog at Buying Individual Health Insurance Blog
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