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Group vs Individual Health Insurance
Posted on 5/29/13 at 9:02 am
Posted on 5/29/13 at 9:02 am
Quick background.
I'm a healthy 36 year old male with only one surgery back in 2008 for diverticulitis. I'm currently insured through work, but the coverage compared to others I've talked to pretty much sucks. I have a high deductible, high co-pay plan with a somewhat high premium. It's just myself on it.
Besides costs, what are the pros and cons of looking for individual plans vs group plans provided by your company? How will Obamacare affect this? Just wondering if this is even worth looking into. TIA.
I'm a healthy 36 year old male with only one surgery back in 2008 for diverticulitis. I'm currently insured through work, but the coverage compared to others I've talked to pretty much sucks. I have a high deductible, high co-pay plan with a somewhat high premium. It's just myself on it.
Besides costs, what are the pros and cons of looking for individual plans vs group plans provided by your company? How will Obamacare affect this? Just wondering if this is even worth looking into. TIA.
Posted on 5/29/13 at 9:21 am to Ignignokt
Group plan particpants generally get better response from the insurance company when disputes arise. If the group threatens to take its business elsewhere the threat is more real than when an individual does the same. The group doesn't have to worry about any member being uninsureable while the individual may be uninsureable due to a pre-existing condition. Note that this should become a thing of the past ecome January 1, 2014 when Obamacare makes denial of coverage for pre-exisitng conditions illegal.
However, the premium price difference is usually large enough to make the group plan more attractive. The only time I see people choose an individual plan when eligible for a group plan is when the group plan coverage doesn't address a specific need of the insured.
However, the premium price difference is usually large enough to make the group plan more attractive. The only time I see people choose an individual plan when eligible for a group plan is when the group plan coverage doesn't address a specific need of the insured.
Posted on 5/30/13 at 8:08 am to Ignignokt
Depending on the size of your employers workforce for cost comparison. I've carried individual full coverage for 18 yrs now, and it has been way less expensive than all small group plans I have observed in our financial strategy firm. Coverage is what you select.
Posted on 5/30/13 at 9:03 am to Poodlebrain
quote:
The group doesn't have to worry about any member being uninsureable while the individual may be uninsureable due to a pre-existing condition. Note that this should become a thing of the past ecome January 1, 2014 when Obamacare makes denial of coverage for pre-exisitng conditions illegal.
Pre-existing conditions can be covered/grandfathered and the mechanism to obtain coverage has been around since the mid 70s. The 'preexisting condition' exclusion is misunderstood, due the lack of knowledge about health coverage in general and the myriad lies Obama and the media have have told about health care.
The OP's question is a common one and many people experience the change from group to individual coverage, usually with changing jobs, or they don't want to pay group rates when they are young and healthy and work with a bunch of old, unhealthy people who have high health costs.
In this case, the individual policy will have a preexisting condition exclusion, with a time limit/waiting period, e.g. 12-18 months, before coverage for preexisting conditions begins.
However, the OP can request a Certficate of Creditable Coverage from the group insurer, verifying he had coverage and for how long, and the individual insurer will either delete the preexisting condition exclusion immediately because you had continuous insurance, and/or reduce the time limit on the exclusion if you had coverage for less than the time limit. Either way, the OP will have indivdual coverage without a preexisting condition exclusion as long as he maintains continuous coverage between both policies.
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