Most Americans get health insurance through their employer. However, individual health insurance is one way to get coverage if you’re not eligible for an employer-sponsored plan or if your company’s plan is too expensive or limited.
Individual plans provide similar benefits as most employer plans. Depending on your income, you may pay even less for an individual health insurance plan than one through an employer.
Individual health plans are available through the Affordable Care Act (ACA) exchanges and outside the exchanges directly through insurance companies. You can’t get denied for an ACA plan. The health law requires that insurers cover anyone who applies.
Now, let’s take a look at when and how you can buy individual health insurance and the types of plans and other options.
1. Protection for you and your family. Your family depend on your financial support to enjoy a decent standard of living, which is why insurance is especially important once you start a family. It means the people who matter most in your life may be protected from financial hardship if the unexpected happens.Maria Carolina Rodriguez
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What do individual health plans cover?
Before the ACA, individual health plans’ coverage varied widely. Insurers could deny your application for insurance or set exorbitant premiums if you had a health condition.
Now, insurers have to cover you regardless of your health history. You qualify for individual health insurance even if you’re pregnant, have a long-term condition like diabetes or a serious illness, such as cancer.
Insurers also can’t charge you exceedingly more because of medical conditions. Health plans additionally can’t cap the amount of benefits you receive. They’re also limited on how much out-of-pocket costs you have to pay.
In addition, all individual health plans must cover a standard set of 10 essential health benefits:
- Outpatient care, including doctor’s visits
- Emergency room visits
- Pregnancy and maternity care
- Mental health and substance abuse treatment
- Prescription drugs
- Services and devices for recovery after an injury or due to a disability or chronic condition
- Lab tests
- Preventive services, including health screenings, immunizations and birth control. You pay nothing out of pocket for preventive care when you see health care providers in a health plan’s network.
- Pediatric services, including dental and vision care for kids
Schedule a no ablication meeting to go over your needs