Group Health Insurance or Individual Health Insurance

With health insurance being such a “hot topic” these days - mainly the implementation of the Affordable Care Act which is widely referred to as the ACA - the subject of individual health insurance versus group coverage is being brought up more often.

The main question being asked pertains to the difference between group insurance and individual insurance. As the name suggests, group insurance refers to coverage provided by a larger body such as a business or corporation. Individual health insurance on the other hand, is merely just health insurance purchased by one person, hence the term “individual.”

Most people are already enrolled in a group health insurance plan or have their own private individual insurance. However, some are finding themselves needing to change from group to individual or vice versa. What kind of effect will that have on you?

What is the Difference Between Group Coverage and Individual Coverage?

For those with group coverage rather than private health insurance, there are a few things that are universal with most plans. For instance:

  1. An employer might pay for your entire premium each month. If not the entire thing, most employers will at least cover some of it.
  2. Should you have to foot the bill for some or your entire insurance premium, most employers provide the option to have that amount subtracted from your paycheck.
  3. Employers will most likely give you an array of coverage and plan options to choose from.
  4. Any questions or confusing elements about your coverage can likely be answered by your employer, eliminating those sometimes tedious calls to insurance agents.
  5. The documents associated with said insurance plan is usually provided by the employer.

In certain circumstances though, some people find that their group coverage provided by their employers are inadequate, or they simply can’t get the coverage anymore, leaving you with that high and dry feeling. Insurance is important so instead of opting to go without coverage, those who can no longer get group coverage choose to enroll into an individual plan.

With the purchase of an individual health insurance plan, one can expect to encounter aspects that differentiate from group coverage including the fact that:

  1. You will now be tasked with shopping around and selecting the appropriate health insurance plan for you and in some cases, your family.
  2. You will have a lot more insight into your health insurance since you personally get to manage your what coverage options and resulting benefits.
  3. You have to actually purchase the plan on your own.
  4. The monthly payments for your insurance premiums are solely your responsibility now.