Individual/Family Health Care Coverage and Insurance provides coverage for immediate family members and those under legal guardianship of the adult members. State laws also govern whether or not domestic partners can be on the same plan. Another major difference between employer group plans and individual/family plans is that in most states, the medical history of each applicant is used to determine whether or not they will be offered the plan and how much the actual Premium for those offered coverage will be. This is often a surprise for those whose experience has only been with employer group plans. If you have concerns or questions regarding health history issues it is best to contact a Licensed Certified Field Broker/Agent ( Click Here) who is familiar with a variety of Health Care Coverage Providers and insurance carrier’s underwriting guidelines. They will be able to advise you on any local or state sponsored programs that may be available in the event someone’s medical history prevents them from being approved. It is also important to have a Licensed Certified Field Broker/Agent ( Click Here) working on your behalf in the event the plan you apply for is not approved as they may be able to help you appeal the decision.

Where do I start, what do I do?

While health care plans are anything but simple, they can be understood with a little bit of preparation and insight from the proper sources. We hope you find our site to be just what you need to help you get a clear picture! Be prepared that Health Insurance is not inexpensive no matter how young or healthy you are. Secondly, now that you are faced with the need to make a decision for yourself or family you may find that you are best served by seeking professional assistance. Even though it is what brought you to this site, surfing the Internet hoping to find the perfect plan is not the best way to proceed. You will also find that relying on the advice of friends and family is also often as much myth as it is fact as well. It is important to realize that your Health Care Plan decision could be one of the most important decisions you may ever make. The following steps are quite important:  

1. Familiarize yourself with as much information as you can using this site starting with the three Cs of health care plans Cost, Coverage and Control (Click Here ); and

2. Take a look quick glance at Pathway to Your Health Care Plan which hopefully make you feel at ease. The intention of this consumer oriented website is to demystify the process and terms used to find the appropriate health insurance individual/family plan for your needs.  

3. Contact a Licensed Certified Field Broker/Agent ( Click Here) who is well versed in a broad selection of health care plans available in your area and can answer your questions as well as help you navigate through the options. While shopping for health insurance on the internet can seem convenient, it can prove to be disastrous. A qualified local agent can help you determine which plans are realistically available to you and which ones create the best value from your perspective. The cost of the plan premium is identical whether you sign up by yourself on the internet or get help from an experienced agent.

Since no two people are the same, settling on a policy for the family really requires everyone’s participation. (See Questions/Guidelines to Follow).

You may have heard talk of consumer driven health plans (CDHP) and be vaguely familiar with the terms FSA, HSA, HIA, HRA, and HRA105. These are not unique plans in and of themselves. Rather, they simply represent minor adaptations to the three basic plan types: Indemnity, PPO, and HMO. What is new is that they introduce certain potential tax savings to those needing individual/family plans similar to what has been available to employers and employees for some time. The downside is that the financial responsibility for all first dollar coverage is shifted to the individual. However, a properly planned HSA or HIA can allow a family to optimize how they actually spend a portion of their health care budget. If you are interested in actually obtaining one of these plans you will most certainly benefit by addressing your specific situation with a Licensed Certified Field Broker/Agent ( Click Here). For further information on CDHP type plans, see FSA, HSA, and HRA Plans or look for the button on the left side of the page at any time later.

How do I determine the best value health care plan for me?

Rather than blindly take someone’s advice you may want to glance at What Health Care Plan Type Should I Buy? to give you an idea of why certain people buy the type of plan you do or Balancing Premium Cost vs. Out-of-Pocket Expenses (Click Here) which will give you some insight on how to get the best value which is a very different question than best price.

Which type plan is right for me?

This is the central purpose of this site. We have developed a concise and simple means to help you easily grasp the essential principles you, and indeed everyone responsible for managing their own health care plan, should be aware of. We refer to it as the three Cs of health care. For more information Cost, Coverage and Control (Click Here ).

Again, we recommend that you seek the insight of a Licensed Certified Field Broker/Agent ( Click Here) who will be able to advise you on what plans and options are realistically available to you in your area.

How can I save money or lower my health care plan expenses?

This question is on everyone’s mind that has to fund their own health care. There are a wide variety of plans available on the market today with prices that range from “too good to be true” to “so expensive who can afford them?”. It is very unwise to shop solely on the basis of price. Some of the really low cost plans are, in fact, not health care coverage or insurance at all! Discount Plans are not insurance, beware! Other low cost plans provide such limited financial protection that people often wonder why they bought it.

Rule of Thumb: If you see two plans that may on the surface appear to be similar and the difference in premium is more than 5-10%, then, most likely, one plan is missing something!  The question is: What does one plan offer that the other one does not and whether the missing features are important to your situation?

The insurance industry is highly regulated and somewhat competitive and as such a 5-10% difference in premium between companies offering identical or virtually identical plans simply allows for minor differences in two company's operating efficiency, investment yields, commission rates paid to brokers/ agents, and etc.  Conversely, you should not assume that if two plans are similar in cost that they actually provide the same coverage.