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Pick the Best Health Care Plan for You

What you need to know about buying medical insurance on your own

Most Americans receive their health insurance through an employer-sponsored plan. But people who are self-employed, work part time, aren't working or work for a business that doesn't provide health coverage are typically on their own.

People in these types of situations often turn to individual health insurance plans — insurance they buy themselves.

Many insurers sell individual health insurance plans. But if you're 50 and older, but not yet 65 and old enough for Medicare, actually getting an individual insurance plan can be a challenge:

  • You may find it harder to find a company that will sell you a health insurance policy, especially if you have a serious medical condition.
  • You may have to undergo a medical exam to prove you are healthy and insurable.
  • You may find that individual insurance costs more than group insurance.
  • You may be provided with fewer benefits than you would through a group insurance policy.

If you're buying health insurance on your own, it's important to shop around and compare health insurance policies and plans.

A first step could be to find out which plans are offered where you live. (Insurance offerings do vary by state.) Then, you can look for insurance that will give you the best health coverage for you and your family. A useful source for researching your health insurance options is HealthCare.gov.

The answers to the following questions can help you compare both the cost and the benefits of the plans you might consider:

  1. How much of my doctor and hospital bills will this health insurance plan pay for?
  2. How much will I have to pay each month in premiums for this plan?
  3. How much will I have to pay as a deductible before the plan begins to pay?
  4. How much will I have to pay for office visits to the doctor?
  5. Does this plan pay for preventive health care (such as screenings for cancer) or vaccines (such as a flu shot) to prevent illness or disease?
  6. Does the plan have rules for people who already have serious, chronic medical problems? Will these rules keep me from getting the care I need? If so, in what way?
  7. What services are covered by this health insurance? For instance, does the plan cover routine surgery, hospital stays, doctor visits, nursing home stays, home health care, and medical equipment and supplies?
  8. Will the plan pay for care at a hospital emergency room or urgent care center?
  9. Does the plan include vision care?
  10. Does the plan include dental coverage?
  11. Does the plan cover prescription drugs?
  12. Does the plan pay for catastrophic medical costs?
  13. Is there an out-of-pocket limit to how much my annual costs could be?
  14. Is there a yearly or lifetime limit to how much the plan will pay for my medical costs?
  15. Are there providers and specialists where I live who will accept this plan?

Next: Your individual insurance options. >>

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