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Individual Health insurance

Individual Health Insurance provided by Innovative Insurance Services, LLC

Most Americans get health insurance through their employer. However, individual health insurance is another way to get coverage if you’re not eligible for an employer-sponsored plan or if your company’s plan is too expensive or limited.

What is Individual Health insurance?

Individual health insurance is coverage that you purchase on your own, on an individual or family basis, as opposed to obtaining through an employer or from a government-run program like Medicare, Medicaid, or CHIP.

What does Individual Health Insurance cover?

Some common examples of the types of conditions that are covered:

  • Outpatient care, including doctor’s visits
  • Emergency room visits
  • Hospitalizations
  • Pregnancy and maternity care
  • Mental health and substance abuse treatment
  • Prescription drugs
  • Services and devices for recovery after an injury or due to a disability or chronic condition
  • Lab tests
  • Preventive services, including health screenings, immunizations and birth control. You pay nothing out of pocket for preventive care when you see health care providers in your plan’s network.
  • Pediatric services, including dental and vision care for kids.

Talk to us to find out if your plan covers these conditions.

Cost of Individual Health Insurance

For a particular health insurance plan, the cost of coverage is determined by certain factors that have been set by law like

  • Age: The health care cost per person covered by a policy will be set according to their age, with rates increasing as the individual gets older. Children up to the age of 14 will cost a flat rate to add to a health plan, but premiums typically increase annually beginning at age 15.
  • Where you live: Health insurance companies determine the set of policies offered and the cost of coverage based on the state and county you live in. So a resident of Miami-Dade County in Florida, for instance, may pay lower rates for the same policy than a resident of Jackson County.
  • Smoking/tobacco use: If you smoke, you could pay up to 50% higher rates for health insurance, though the maximum increase is determined by the state.
  • Number of people insured: The total cost of a health plan is set according to the number of people covered by it, as well as each person’s age and possibly their tobacco use. For example, a family of three, with two adults and a child, would pay a much higher monthly health insurance premium than an individual.

When comparing individual policies, look at what each policy covers in addition to monthly rates and fees. If all this sounds confusing, don’t worry; our team of experts are ready and waiting to partner with you  in finding the right health insurance solution for you. We are here to help with all your questions and concerns so that you can make an informed decision.

What is a Qualified Health Plan and when can I enroll?

Private health plans are offered by partnering insurance companies either on the exchange (MNsure) or
off the exchange. These are known as qualified health plans (QHP).

All private QHPs offer the same core set of benefits
called essential health benefits, which include: 

  • Preventative care; mental health and substance abuse services;
  • maternity care;
  • emergency services;
  • prescription medications;
  • hospitalization;
  • limits on copays, deductibles, and annual out of pocket costs. 

The annual enrollment period (AEP) is November 1st  – December 15th unless extended by the Governor.  Plans selected in the AEP start January 1st.  All QHPs are guaranteed issuance (you cannot be denied for pre-existing conditions). 

The EIP is the only time one can enroll in a QHP unless an individual or family qualifies for a Special Enrollment Period (SEP) which includes:

  • Loss of group coverage / employment / COBRA;
  • Moved to an area where your current coverage is not available;
  • Employer adds or offers an Individual Health Care Reimbursement Account (ICHRA) coverage outside of the AEP;
  • Government declares a Special Enrollment Period outside of the AEP.

What is MNsure?

It is Also known as The Exchange.  Participating health insurance companies offering QHPs post benefits and rates on The Exchange. 

MNsure also determines if you qualify for various government programs.

MNsure is NOT an insurance company nor a government health coverage program.

What happens if I miss enrolling at the designated periods?

You are not allowed to enroll in a QHP outside of the designated enrollment periods.  We do offer other coverage plans that are not a QHP, however those plans are subject to underwriting for pre-existing conditions.

Need Dental Insurance or to Enhance your Individual Health Plan?

Our team can assist you in finding dental coverage to meet your short and long term
needs. 

 If you are on a high deductible plan or have a
high out of pocket maximum, talk to our experienced team to tailor your health plan to fit your needs.

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