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Buying your own health insurance

47 million Americans go without health insurance. Here is your guide to buying insurance on the private market.

By Gerri Willis






To be clear, we're talking about people here who don't qualify for Medicaid or COBRA. If this is you, you may need to buy insurance in the private marketplace.

There are obvious downsides here. Cost is one. People who don't have health insurance pay about $2, 260 in out of pocket costs per year -- that's twice as much as someone who is covered under an employer's plan according to Consumer Reports. And in many states, you can't even get coverage on the private market if you have a pre-existing condition, like diabetes.

But ... the reality is that going without health insurance is dangerous. High medical bills is a main reason why people declare bankruptcy. But you don't have to get an all-comprehensive policy. You can opt for short-term health care or catastrophic insurance coverage that will kick in when there's an emergency.

How to shop for individual insurance plans
There are basically three ways to go.

First, check out insurance comparison Web sites like eHealthinsurance.com. Use it to get a range of individual health insurance policies and to compare prices and benefit levels.

Next, go to your state insurance department's Web site. Here you may find companies selling individual coverage in your state. And the insurance department may also provide complaint records on individual insurance companies.

Finally, consider using a health care broker who knows your local market. Brokers can help you shop for price. They'll also know what company is more liable to accept you based on your health conditions. The best part is that you won't pay a dime out of pocket says Amir Mostafie at eHealthinsurance.com. They get a commission paid by the insurance company that you sign up with.

To find an agent in your area, go to the National Association of Health Underwriters at Nahu.org.

Know your eligibility
You don't automatically qualify for Medicaid just because you have a low income. It also depends on your family status -- if you have kids etc.

To find out what eligibility requirements of health care programs like S-Chip or programs for the elderly, go to coverageforall.org.


Source: CNN Money

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Here are some additional tips:




Use a health-insurance broker who knows your market. Brokers not only will help you shop for price, they'll also know if a company has a reputation for raising premiums or hassling policyholders who file claims. If necessary, a broker can find a group for you to join or help you sign up for your state's high-risk pool.

Finding a broker can be a task in itself. Many life- and auto-insurance agents don't deal in health insurance because the rules are complicated and the commissions low. But they may be able to refer you to a specialist. The National Association of Health Underwriters can also put you in touch with member agents in your area.

Check out prices on the Web. In most states, eHealthInsurance.com can give you immediate quotes from several companies, including many BlueCross/BlueShield plans, and will also spell out what benefits you'll get for the price. Another site, DigitalInsurance.com, lists prices for a different group of health-insurance companies. Both sites are most useful in competitive markets such as California, but won't help much in Maine and other restrictive states. Taking a peek at the sites may be worth your while even if you're happy with your current plan.

Visit your state insurance department's Web site. You'll probably find a list of companies selling individual coverage in your state, including those that aren't handled by brokers. For example, many BlueCross/BlueShield plans -- often one of the few choices available in highly restrictive states -- prefer to deal directly with customers, or offer such low commissions that they aren't worth a broker's time. The insurance department may provide shopping tips for your state, as well as insurance-company complaint records.

Look into your state's insurance pool if you have been turned down for coverage because of your health. In Texas, for example, anyone who can't get coverage elsewhere must be covered by the high-risk pool, although prices can be steep. States with guaranteed coverage, such as New Jersey, don't have high-risk pools because regular health-insurance companies are required to cover everyone.

Consider taking advantage of federal COBRA legislation if you have left a company that provided group coverage. If your previous employer has 20 or more employees, the company is required by law to let you continue your group coverage for up to 18 months. Some states have similar laws for smaller employers. You generally foot the entire bill yourself, plus up to 2% in administrative charges, which can increase your costs considerably.

COBRA coverage tends to be a good deal if you're in poor health or in a market with few choices, or you want to stick with your current doctors. But because group plans often have more bells and whistles than you'd buy yourself, you might find a better deal by shopping on your own.

Form your own small group if that's an option. Even for tiny groups, employer group policies are often subject to different rules, are more competitive, and offer lower prices than individual policies.

In New Jersey you can form a group with as few as two employees, including yourself, as long as each employee works a minimum of 25 hours per week and you pay the employer's share of social security taxes for your workers. And group policies can cost 20% to 50% less than individual coverage, says Barbara Ziegler, a health-insurance agent in Brick, N.J. In Washington, another state with few choices in individual health insurance, self-employed people can form a group of one and have a much wider selection with more competitive prices. But you have to submit tax forms that prove you really are a business.

Join an association that has group coverage. In some areas, such as Rochester, N.Y., the local chamber of commerce offers some of the best health-insurance options around, says Alan Ziegler, an employee-benefits consultant and broker.

Association plans tend to be more attractive in states such as New York that don't have many options for individuals. In states where there's more competition, they can end up being magnets for sick people, with spiraling prices. You may not have this option at all, because some state laws are so restrictive that it's "virtually impossible" for association plans to operate, says Jessica Waltman of the National Association of Health Underwriters.

If all else fails and you don't want to go without coverage, you may have to bite the bullet and get a job that offers health insurance as an employee benefit.



Source: Kiplinger.com

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