Individual health insurance covers the medical expenses of
only one person or family. Unlike group insurance, you purchase individual
insurance directly from an insurance company. When you apply for individual
insurance, you are evaluated in terms of how much risk you present. This is
generally done through a series of medical questions and/or a physical exam.
Your risk potential determines whether you qualify, and how much your insurance
What will the insurance company want to know?
Before issuing an individual insurance policy, the insurer will want to know
everything about your personal health history. It is unwise to try to hide a
pre-existing condition from your insurer, since many insurers use information
from the Medical Information Bureau (MIB) to determine whether an applicant is
insurable. If the insurer doesn't want to cover a particular health condition,
you may still be able to get a policy with an exclusion rider.
What are the benefits of individual coverage?
If available, group insurance is generally a better option, since it is usually
more comprehensive and less expensive than individual insurance. However,
individual coverage is infinitely better than being uninsured in the event of
illness or injury. Although you may think you can do without health insurance,
you are taking a major risk if you choose not to get coverage. An unexpected
illness or serious injury can put you and your family in financial peril.
In a group insurance situation, the provisions of the policy
are negotiated between the insurer and master policyowner (usually an employer
or association). With individual insurance, you are directly in control of your
policy. You can negotiate to have certain provisions included or excluded, and
you can often choose your deductible amount and co-payment percentage. Keep in
mind, however, that these things will affect your premiums.