Individual health insurance is health coverage that is purchased by an individual or a family and is not tied to a job or a group of policyholders. 

Many people get health insurance through their employers. However, if you do not currently participate in your employer’s health plan, or if your employer doesn’t offer coverage, obtaining individual health insurance is a good method for ensuring that you and your family will be protected from very high costs in the event of a medical emergency. 

Talking with an C.J. Noel Insurance Services agent is a great first step in determining the right coverage for your needs and budget. We have a variety of coverage options and the expertise to guide your choices. 

There are also some other ways to seek individual health insurance, including those listed below.  

Obtain Insurance in the Individual Market 

The Health Insurance Marketplaces (also known as Exchanges) are some of the most common places to buy health insurance and apply for Medicaid. Created by the Affordable Care Act (ACA), the Marketplaces are designed to help you easily find health insurance that fits your budget. Different states may have different Marketplaces and available options—there is also a federal Marketplace, HealthCare.gov. Open enrollment for ACA is offered from November 1-December 7, 2021.

Qualified health plans in the Marketplaces are sold and run by private companies, and every plan covers a core set of 10 essential health benefits which include emergency, prescription drug and mental health services. Additionally, all plans offered in the Marketplace must provide free preventive care, with 100% of the costs paid for by insurance companies. 

Get on Someone Else’s Plan 

If your spouse or domestic partner has an employer-sponsored plan that is open to participants’ family members, consider joining and enrolling your children as well.  

Additionally, the ACA extends coverage eligibility for young adults up to age 26 on plans offering dependent coverage, regardless of their marital or student status. 

Seek Insurance Through COBRA and State-sponsored Programs 

The Consolidated Omnibus Budget Reconciliation Act (COBRA) provides certain former employees, retirees, spouses, former spouses and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events, such as having work hours reduced and subsequently losing employer-based coverage. 

COBRA coverage is usually more expensive than health coverage for active employees, so individuals may wish to consider other options, such as Exchanges, if they ever lose their employer-sponsored coverage. 

Gain Insurance Through Protections Under HIPAA 

Under the Health Insurance Portability and Accountability Act (HIPAA), at least one private insurer must sell you a policy if you meet all of the following conditions: 

• You previously had 18 months of coverage without a break for more than 63 days.

• The last day of your coverage was through your former or current employer.

• You do not have a COBRA or mini-COBRA option available.

  

Use Medicaid or Other State Programs, as Applicable 

Medicaid provides health coverage for some low-income individuals, including families and children, pregnant women, the elderly and people with disabilities. People who do not qualify for full Medicaid benefits may still be eligible for breast cancer and cervical cancer screenings or assistance with certain treatments. 

The rules for Medicaid enrollment differ slightly from state to state. You can visit www.medicaid.gov or use your state’s Marketplace to determine whether you are eligible for Medicaid coverage in your state. You can also consult your local health department to see if there are any public coverage options available in your area. 

You may also qualify for Medicare coverage. Open enrollment for those individuals 65+ goes from October 15-December 7, 2021. Visit Medicare.gov to learn more. 

Conclusion 

With all the different health plans available out there, it can be difficult to select the plan that best meets the needs of you and your family, and, ultimately, your budget. While it can be tempting to pick the plan with the lowest premium, you don’t want to be is surprised by high out-of-pocket costs or network restrictions when seeking medical care. 

Speak with C.J. Noel Insurance Services for assistance in determining your best available health insurance options.