Whether you're enrolling in an individual health plan for the first time or looking to switch your current benefit, choosing an individual health insurance policy on your own can be difficult. Many individual health insurance plans are available on the market, but how do you know which one is right for you?
Choosing a health insurance plan doesn't have to be complicated or time-consuming. Nowadays, several innovative organizations are dedicated to helping individuals compare health insurance policies, answer questions and concerns, and virtually sign up customers for their benefit plan.
To give you a better idea, let’s go over everything you need to know about individual health insurance plans and the companies that provide resources to help you choose the right one.
What is an individual health insurance plan?
An individual health insurance plan is a policy that individuals or families purchase on their own, not through an employer (otherwise known as group health insurance). You can buy individual health plans directly from a health insurer, a broker, or a state or federal health insurance exchange, also known as a marketplace.
When buying your own individual plan, you have more control over plan design and level of coverage. They can be tailored to fit you and your family more closely to ensure you’re getting your specific healthcare needs met. And in comparison to employer-sponsored group health plans, many individual policies tend to be more manageable in cost.
In addition to health insurance, supplemental health plans, such as dental, vision, and disability insurance can be purchased on an individual basis. Employers do not typically provide these types of plans, so they’re chosen and paid for directly by individuals. Because individual plans aren’t tied to businesses or employment, you can keep your policy for as long as you want.
What are the four categories of individual health plans?
When understanding individual health insurance, it’s important to know your terminology. You probably know there are many benefit plan types, but there are also four primary categories, or metal tiers, within the health insurance marketplace.
The plan categories are bronze, silver, gold, and platinum. The higher the level, the more the insurance company from that health plan category will pay on average toward healthcare expenses. The lower the level, the less the insurance company from that health plan category will pay. On the other hand, the higher the tier, the higher the higher your monthly premium amount can be.
The following shows the approximate percentage of costs for medical care with each plan category:
- Bronze: You pay 40%, and the health insurance issuer pays 60%
- Silver: You pay 30%, and the health insurance issuer pays 70%
- Gold: You pay 20%, and the health insurance issuer pays 80%
- Platinum: You pay 10%, and the health insurance issuer pays 90%
According to the ACA, all marketplace health plans will cover the ten essential health insurance benefits. It’s also important to note that quality of care isn’t impacted by your tier. Additionally, tiers can have plans of any network type. For example, there are gold HMO plans and gold PPO plans.
Who should purchase individual health insurance?
If you’re young and generally healthy, you may think you don't need health insurance. But that’s not a good guideline to follow. If you’re self-employed, a small business owner, coming off your parent’s policy, or your job doesn’t provide employer-sponsored health insurance, you should consider purchasing your own individual health insurance plan.
Rising healthcare costs can be expensive and sudden if you have a medical emergency. Getting an arm or leg cast can cost $863 and the average insured overnight hospital stay costs about $11,700. If you don’t have the money to pay for out-of-pocket for unexpected medical costs, you can quickly find yourself in serious medical debt.
An individual health insurance policy can help cushion the blow if you experience a medical crisis or serious life event. And because some plans, like high-deductible health plans (HDHPs) or other bronze plans, are typically cheaper in monthly premiums, affording an individual plan may be more cost-effective than you think.
Companies that can help you shop for individual health insurance
If you’re ready to shop for individual health insurance, you may be wary if it’s your first time. But finding the right policy that fits your needs doesn’t have to be complicated.
There are many organizations with cutting-edge technology to help you browse, compare, and enroll in a plan in a short amount of time. Most even have advisors to act with your best interests in mind and offer you support on your way to achieving your health insurance goals.
The following top companies offer assistance and resources to help you pick the perfect individual health insurance policy. We’ll go over a little about each organization and how they can work for you and your family.
Stride Health makes it easy to manage your health insurance. They were founded on one simple idea—getting affordable health insurance benefits should be simple. Stride saves you time and money when shopping for insurance, and their team is available year-round to work directly with your health insurer to resolve issues, like a surprise bill or finding a doctor.
Now, nearly 2 million consumers use Stride to find affordable health, dental, vision, and life insurance, manage their income and taxes, and save money on everything from prescriptions to online doctor visits and more.
Friday Health Plans
Friday Health Plans is a healthcare management company built for today’s health insurance industry. Headquartered in Denver, Friday focuses on offering low prices so more people can easily afford health insurance and works to provide operational efficiency, top-notch customer service, and a smart technology platform.
With Friday Health Plans, members choose a plan that delivers the health benefits they value most. While the ACA requires every health plan to offer one free primary care visit, we offer unlimited primary care visits, including mental health visits.
Whether you visit your doctor in person or through our telemedicine partners, Friday has just what you need to access personalized healthcare and essential health services.
Launched in 2015 in Austin, TX, KindHealth is an insurance discovery platform offering health, dental, vision, life, accident, injury, cancer, and Medicare insurance on a digital AI-powered marketplace including 250+ health insurers and the Healthcare.gov marketplace.
Their cutting-edge technology platform recommends different plans, consolidates health plan information, and acts as an advocate to book appointments and dispute bills, so clients can choose a health plan easily without going to several company websites and marketplaces.
Whether online or by speaking to an advisor, KindHealth provides personalized insurance solutions and professional health services to their customers seamlessly.
Gravie is a health insurance marketplace designed to help employees through their employers choose and purchase insurance, as well as manage healthcare expenses. With an insurance plan through Gravie, employees get better health coverage options, including individual access to networks of top doctors, hospitals, free expanded care health services, pharmacy discounts, and other perks.
Gravie has been at the forefront of driving change and improving the healthcare industry by creating innovative health benefit solutions that put consumers first.
Their mission is to improve the way employees purchase and access healthcare in the U.S. With Gravie, you can choose personalized health insurance benefits that meet your individual needs, lifestyle, and budget.
Founded in 2005, GetInsured’s belief is that technology can improve access to healthcare. For over a decade, they’ve built online health insurance shopping and enrollment platforms that make it easy for consumers to shop, compare, and enroll in a benefit plan that best fits their individual and family needs. Since the start of the ACA, GetInsured has enrolled Americans in about 12 million health plans.
GetInsured is now the leading provider of health insurance technology and customer service solutions for state governmental entities, employers, and consumers, within seven states. Through constant innovation and improvement, GetInsured continues to provide outstanding customer solutions, reliable service, and impeccable quality.
In 2013, HealthSherpa launched an easier way to shop for and enroll in ACA marketplace plans, and so far, they’ve helped nine million people gain coverage. They are a Healthcare.gov certified web broker, giving consumers, employers, and nonprofits a platform for enrolling individuals and families in subsidy-eligible health plans.
HealthSherpa's mission is to help every American have the security of health insurance coverage. They provide individuals access to tools to choose their plan and best use their insurance after enrolling.
Their team of Advocates are experts in their field, and they’re ready to help all year round. With support via phone, email, and chat, consumers can get quick and easy guidance on health information.
Oscar Health started in 2012 to create the kind of health insurance company that behaves like a doctor in the family. They believe every American deserves access to affordable, high-quality healthcare in their life. Powered by their own full-stack technology platform, they have built a suite of services to leverage personalized data and help their members find quality care they can afford.
Oscar is proud to have earned industry-leading levels of trust, engagement, and customer satisfaction from their approximately one million+ members. As they keep bringing quality healthcare experiences to new members, states, and markets, their goal of building engagement, providing guidance, and helping their members live healthier lives continues.
There is no right or wrong answer when it comes to picking the perfect individual health insurance policy. If you’re nervous about tackling the federal or state marketplace by yourself, a concierge health insurance company can list the pros and cons of each plan, compare costs, and guide you through the shopping and enrollment process.
Though health insurance can be confusing at first, it's important for your overall health and wellbeing in the long run, especially if you have a medical emergency. Luckily, with new organizations geared towards assisting you becoming more popular, there are experts out there waiting to help you get the health insurance coverage you need.