Group health insurance may not always be the best

With the cost of health care rising, more and more Americans no longer receive health coverage through their employers – if you’re healthy, that may not be a bad thing. Depending on the cost of your employer’s health insurance, an individual policy may cost less. With an individual policy, you gain more control over your own benefits and costs, while with the group you have very little say in the decision. Individual health insurance is not tied to your job and can give you peace of mind later if you lose your job or don’t have insurance. The ability to reevaluate what is important to you when necessary can save you hundreds of dollars. As the economy causes more employers and more people to tighten their budgets, it may be time to look at your health coverage differently – before it’s too late.

Group health insurance can be expensive compared to individual, and in the individual insurance market, pre-existing health conditions can cause denial of coverage. By law, no one in a group insurance plan can be denied coverage due to medical conditions like heart surgery, diabetes, bipolar, etc. And having to insure these people creates a high financial risk for insurance companies. To help with the costs associated with risk, the state of Missouri allows insurance companies to increase premiums by up to 107% over the preferred rates for healthy people. * Rules vary from state to state, so check with your individual state’s department of insurance. The medical underwriting determines the medical risk associated with the group. Then the premiums increase accordingly and everyone in the group pays the same cost for these medical conditions, not just the conditions. Assessing the percentage of your country of employment for you and your family’s health insurance, plus the portion you pay, is important in determining whether an individual policy would be less or more favorable. Your family’s portion of coverage could be drastically more expensive if you pay 100% of the premium yourself and your group has many health conditions. Insuring family members with a separate family policy has become more common as families try to save.

With group insurance, you have less control over deductibles, coinsurance, and benefits, unless you are the owner or the decision-maker, whereas with individual insurance the choice is yours. What one person can afford, another may not. This cannot always be taken into account during the decision process when it comes to group health insurance. Needs can vary from one person who visits the doctor weekly to one who can only see one doctor every few years. Why pay higher premiums for benefits you may never use? Control over your money and your health for your individual situation can be more easily maintained through an individual plan, not through a group.

Employer-paid insurance benefits can be nice, but what if you lose your job? Your employee health benefits are only valid while you are employed. COBRA may be available, but you are 100% responsible for the health insurance premium. In COBRA, you are responsible for the part that your employer has been covering. Another scenario to consider is what if during your employment you underwent open heart surgery, were diagnosed with diabetes, had a severe car accident, or are unable to work? Your only options would be COBRA if there is an option and only during the allowed benefit period, a HIPPA plan, a state option where available, or without insurance. The Missouri Health Insurance Fund is the resource of the state of Missouri, but it is very expensive and has limitations. With an individual plan, you own it for as long as you pay your premiums. If the premium is considerably less than your group insurance premium, it may be easier to pay.

Just as the costs of group insurance are increasing, so are the costs of individual insurance. Premiums increase with age and claim history in your area, not with use of your personal insurance with individual coverage. Insurance companies are constantly fighting for business, and along with this battle, they will bring out new plans, lower rates, or both frequently. As long as you stay healthy, your health policy should be reassessed annually to help you save money. The job of an independent agent should include providing you with annual updated quotes, and most carriers should be available through the agent for honest comparisons. Individual policies cannot be affected by other health conditions and / or decisions, but are based solely on you and allow you some freedom of choice.

Rising insurance costs are currently causing more businesses to cut profits or eliminate insurance altogether. Consumers are also trying to cut their own costs as our economy raises more concerns, what better time to save money than now? Evaluating your employer’s health insurance options or purchasing an individual insurance policy could save you hundreds of dollars a year. Research all the options available to you and then call an independent agent for a free second opinion. Most agents are happy to sit down, help educate you, and provide an honest comparison of what is available for your situation. Make sure to ask all the questions you may have, after all, you have nothing to lose and only money to gain.