Health Insurance for the Self-Employed – Part 3

Questions to Help you Understand Your Needs for Health Insurance

When you’re looking at purchasing health insurance, it’s important to understand what your needs are. In this post I’ll discuss seven questions that are important to ask when you’re shopping for health insurance. 

  1. Who will be covered under this plan? Why it matters: It may sound like a dumb question. You probably want to cover yourself and your dependents. But ask yourself: does anyone in your family have other coverage options? If you really can’t afford to cover everyone, who needs coverage most, and why? You may actually be able to save money by covering different members of your family separately under two or more plans.
  2. Do you maintain savings or do you live paycheck to paycheck?  Why it matters: If you don’t maintain a cushion of funds in the bank, you may want a health plan with a low deductible, or none at all. If you do keep a savings and can afford a higher deductible if necessary, you may be able to find a plan with lower monthly premiums.
  3. How often did you visit the doctor last year? Why it matters: If you visit the doctor regularly, it may make sense to pay a higher monthly premium in order to keep your office visit copayment and deductible low. If you rarely visit the doctor, maybe you don’t need robust coverage for preventive care.
  4. How much did you spend on healthcare last year? Why it matters: If you spend a lot on health care, it’s important to know what you spend it on and if you expect to spend at the same pace. If these are recurring costs (for prescription drugs, for example), make sure that the plan you select covers these services. If yo u don’t spend much on health care, then you could save money with a plan that provides less generous coverage for office visits or prescription drugs.
  5. Do you have any pre-existing medical conditions? Why it matters: Some pre-existing medical conditions (like heart disease, cancer, or diabetes) can make it difficult to get approved for Individual and family coverage. If you’re concerned, a licensed eHealthInsurance agent can help direct you to insurance companies more likely to approve your application.
  6. Are you eligible for group health insurance coverage? Why it matters: In most states, self-employed persons buying health insurance on their own need to purchase individual and family plans. However, some states allow persons with business licenses to purchase small business/group plans, even without employees. If you have a pre-existing medical condition, a small business/group plan may be a better option, since with group, you can’t be turned down for coverage. To learn more about group health insurance, skip to the “Small Business Owner” section of this guide. Find out if you qualify for group health insurance by contacting your state Department of Insurance.
  7. Are any specific benefits necessary or irrelevant? If you’re a regular user of prescription medication, make sure you find a plan that covers prescriptions at a co-payment level you can afford. If it’s possible you or your spouse could become pregnant, pay close attention to maternity benefits too. If you don’t need prescription drugs or maternity benefits, you could save money.

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