Many people have questions regarding which health insurance is best for them and their individual needs. It is important to understand that not all policies and certainly not all insurance companies are alike. The more you learn and understand about health insurance in general, the more likely you are to end up with coverage that works for you. It is important to keep in mind that there are major differences between individual and group health insurance coverage.
In order to purchase individual insurance, you typically must answer a series of questions about your overall health and many companies insist on an examination by a physician just to rule out any underlying health issues. An individual may be denied individual health insurance coverage due to his or her health, personal habits, age, annual income, medical history and a number of other contributing factors. Insurance companies may also issue individual health insurance policies that are limited in what they will cover particularly to those who have pre-existing medical conditions.
Group health insurance however, works much differently. Employers that want to offer the option for medical coverage to their employees typically choose a group plan that will guarantee coverage to all employees regardless of age, health or annual income. An employee who has had trouble in the past receiving health insurance coverage due to long-term medical conditions can typically receive group health insurance through an employer. There are typically restrictions placed on employees who have been recently hired however. Many companies restrict signing up for group insurance coverage for a specific number of days or months. Once an employee has reached that time limit, he or she is welcome to apply for coverage. In some companies however, employees are eligible for health insurance coverage on the very first day of their employment.
Group health insurance provides employees with a much lower alternative to individual insurance coverage. This is typically because it takes much less money for an insurance company to underwrite a policy that covers a larger number of people. The cost of selling and servicing one plan for several people as opposed to individual plans for the same number of people is much lower. Group insurance policies also tend to be much more flexible in their coverage than individual policies.
There are basically four distinct types of group insurance coverage that employers offer to employees. These are Accidental Death and Dismemberment or AD&D, Disability, Life and Medical or Health coverage. Many employers also offer vision and dental insurance coverage. Although there are currently no federal laws in place that require companies to provide group health insurance to their employees, many companies do so to help ensure that employees and their families have the medical coverage that they need.
When enrolled in a group health insurance plan, every member that is covered under that plan must meet his or her own deductible before the insurance will begin covering medical expenses. Those that include family deductibles typically limit the amount that an individual family must pay before benefits kick in. Typically, only two or three members of the family will need to meet the individual deductible before benefits begin. When enrolling in a group insurance plan, individuals will receive information about the plan, the deductible, premium and exactly what services are covered. Under most group plans, routine visits to a physician are covered at least in part. There may be a co-pay for physician office visits, depending on the insurance company that writes the policy and the policy itself. It is important to keep in mind that insurance companies will limit the amount of expenses that they incur. They typically place caps on allowable benefits for specific services or procedures. They may also limit the number of days for certain specialized care such as skilled nursing and home health care.