What Is Individual Health Insurance

What is individual health insurance?

What Is Individual Health Insurance

This is a coverage that a person buys independently. It can be sold to a single individual, to a parent and dependent children, or to a family. The majority of Americans get their health insurance coverage through an employer or through a government program, but five percent of the population purchases private health coverage on an individual basis. Each state separately regulates how individual policies may be marketed and sold.


How can one buy individual health insurance coverage?

Independent agents and brokers sell insurance plans from many health insurance companies, and they can help its members find the coverage that best suits their individual needs.

Agents and brokers also provide service on the policies they have sold and can help one process claims or with anything else he/she needs regarding his/her policy. The insurance companies for which agents and brokers sell coverage pay them a commission for their work, so an individual will not be charged a direct fee he/she wants to use the services of an agent or broker.

How is individual health insurance different from group health insurance?

Individual health insurance is very different than group health insurance, which is the type of insurance that is offered through an employer. Since laws mandating what types of services must be included in individual policies are often different than those dictating what must be included in group policies, benefits are generally less extensive than what most people would receive through coverage they have through work. Individual consumers may be surprised to learn that some benefits that may be considered “standard” in a group policy, like maternity coverage or substance-abuse treatment, may not be included in an individual plan. Sometimes individual health insurance consumers have the option to pay extra for coverage of additional services like maternity coverage. This extra coverage is referred to as an optional rider.


Cost is often the primary factor for individual health insurance consumers, which is another reason why the benefits included in individual policies are often simpler. In addition, deductibles (the amount one has to pay before insurance benefits begin) and cost-sharing (the fees you pay directly to medical providers at the time of service) are also generally higher.



Cover for Specific Activities

Cover for specific activities such as various sports, skydiving, and even bungee jumping, will be available under an individual international health insurance plan.

Top-Up Plans

If one’s company insurance policy doesn’t cover him/her for everything he/she needs coverage for, top up plans are available to make up the difference. He/she can take out individual top-up plans for dental insurance, optical insurance, maternity insurance, etc.

Direct Billing

Several plans can offer members direct billing. This means that their insurer will pay their medical costs directly to the hospital at no initial cost to them. They won’t need to worry about paying up-front for any treatments or having to claim back the money with their insurer later on.

Demonstrating Flexibility

Coverage can range from something as serious as chronic conditions, to

short-term travel or maternity cover.


Inpatient Outpatient Cover

An in-patient only plan would allow for a lower premium but would still cover its member in emergencies for hospitalization and surgery costs. A deductible (excess) can also be included to keep your premiums low.


Renewable Policies

An individual can get individual international insurance plans that are guaranteed renewable, meaning that medical costs continue to be covered by the insurer for your whole life.

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Calculating Premiums

Individual International health insurance premiums are not dependant on nationality or occupation but are instead based on one’s country of residence and age. Other factors to be taken into account include one’s desired benefits and area of coverage.

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In almost every state, individual health insurance coverage can be purchased through licensed health insurance salespeople known as agents or brokers.