Group Health Insurance May Not Always Be the Best

With the rising cost of healthcare, more and more Americans’ are no longer provided health coverage through their employers, if your healthy that may not be a bad thing. Depending on your employer’s health insurance cost, an individual policy may cost less. With an individual policy you gain more control over your own benefits and cost, while with group you have very little say in the decision. Individual health insurance is not tied to your job and can provide you with piece of mind later if you lose your job or become un-insurable. The ability to reevaluate what’s important to you when needed can possibly save you hundreds of dollars. As the economy causes more employers and more people to tighten their budgets, it may be time to look at your health coverage differently, before it’s too late.

Group health insurance can be expensive in comparison to individual, and in the individual insurance market pre-existing health conditions can cause denial of coverage. By law no one in a group insurance plan can be denied coverage due to medical conditions such as heart surgeries, diabetes, bi-polar etc. and having to insure these individuals creates a high financial risk to the insurance carriers. To help with those cost associated with the risk, the State of Missouri allows insurance carriers to increase premiums as much as 107% over the preferred rates for healthy people.* Rules vary state to state so check with your individual states’ department of insurance. Medical underwriting determines the medical risk associated with the group. Premiums are then increased accordingly and all group members pay an equal cost for these medical conditions, not just though with the conditions. Evaluating the percentage your employer pays for you and your family’s health insurance, plus the portion you pay, are all important in determining if an individual policy would be less or more favorable. Your family’s portion of coverage could be drastically more expensive if you are pay 100% of the premium yourself and your group has lots of health conditions. Insuring family members on a separate family policy has become more common as families try to save.

With group insurance you have less control over deductibles, co-insurance and benefits unless you are the owner or decision maker, while with individual insurance policy the choice is yours. What one person can afford, another may not be able to. This can not always be taken in to account during the decision process when it comes to group health insurance. Needs may vary from one person who visits the doctor weekly to another who may only see a doctor every few years. Why pay higher premiums for benefits you might never use? Control over your money and your health for your individual situation can be maintained easier through an individual plan, not through a group.

Employer paid insurance benefits can be nice but, what if you lose your job? Your employee health benefits are only good while you are employed. COBRA could be available but you are 100% responsible for the health insurance premium. On COBRA you are responsible for the portion your employer has been covering. Another scenario to consider is what happens if during your employment you have had open- heart surgery, was diagnose with diabetes, had a severe car accident or can’t work? Your only options would be COBRA if there is an option and only during the allowable benefit period, a HIPPA plan, state option where available, or to go without insurance. The Missouri Insurance Health Pool is the state of Missouri’s resource, but it is very expensive and has limitation. With an individual plan you own it for as long as you pay the premiums. If the premium is considerably less than your group insurance it could be easier to pay.

Just as group insurance costs are on the rise, so are the individual insurance costs. Premiums do increase with age and your area’s claims history, not by your personal insurance usage with individual coverage. Insurance carriers are constantly battling for business and along with this battle they will bring out new plans, lower rates or both frequently. As long as you remain healthy, your health policy should be re-evaluated annually to help save you money. An independent agent’s job should include providing you with annual updated quotes, and most carriers should be available through the agent for honest comparisons. Individual policies can not be affect by other health conditions and/ or decisions, but are based on you alone while allowing you some freedom of choice.

Escalating insurance costs are currently causing more business’ to cut benefits or eliminate insurance all together. Consumers are also trying to cut their own cost as our economy brings more worry, what better time to save money than now? Evaluating between your employer health insurance options or purchasing an individual insurance policy could save you hundreds of dollars annually. Investigate all options available to you and then call an independent agent for a free second opinion. Most agents are happy to sit down, help educate you and give you an honest comparison of what is available for your situation. Make sure to ask all the questions you may have, after all you have nothing to loss and only money to gain.

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