Individual vs Group Health Insurance: What You Need to Know

When it comes to options for insurance plans, individual and group health insurance have their fair share of benefits and drawbacks. Individual health insurance covers a single policyholder, while group health insurance is for companies to insure their employees.

For instance, individual health insurance is flexible and not tied to your employment but at the cost of higher premiums and potential pre-existing condition exclusions. Meanwhile, group health insurance offers greater coverage but at the cost of being company-owned and tied to your employment.

Today, we will be going over the differences between individual and group health insurance, as well as each of their share of benefits and drawbacks.

What is Individual Health Insurance?

Individual health insurance is a health insurance plan that you purchase independently as opposed to securing the policy through an employer. Individual health insurance covers only the individual policyholder and is not tied to your employment status.

However, depending on the particular individual health insurance plan you select, premiums may be expensive and pre-existing conditions may either require additional costs, longer waiting times, or may be completely excluded.

But, another good thing is while one insurance provider may outright turn down your application for a health insurance policy, it doesn’t necessarily mean every other company will do the same.

Some other insurance providers may allow you to sign up for a health insurance plan despite any pre-existing conditions, but at the cost of either additional fees or a particular waiting period.

What is Group Health Insurance?

Group health insurance is a health insurance plan offered to a group of employees by their employer as opposed to each individual employee securing health insurance on their own. This type of insurance plan offers greater coverage but at the cost of employment dependency.

Where this makes up for the limitations of individual health insurance is employees can get their pre-existing conditions covered with ease and plans offer greater coverage for considerably cheaper.

This is because insurance providers will cover individuals with pre-existing conditions in bulk as there are enough people to offset coverage expenses.

However, aside from being owned by the employer and not the policyholders, the coverage is tied to the employee’s employment status which means they could lose their coverage in the event of employment termination or resignation.

Expats working overseas may want to consider securing their own insurance plans to cover their unique healthcare needs, such as maternity coverage in the event of pregnancy while abroad. For more information, click the link below:

Pre-Existing Conditions: Maternity Coverage Options for Expats

What to Consider When Getting Individual Health Insurance

When looking to secure an individual health insurance plan, it’s crucial to consider factors such as your budget and specific healthcare needs as well as other factors such as whether or not you have particular preferences for specialists or hospitals.

Below are factors to consider when you’re seeking individual health insurance for yourself or a family member.

• Your Budget:The first factor to consider when securing individual health insurance is your budget. Try to choose the health insurance plan that best matches your comfortable budget, but don’t forget to also look beyond budget comfortability as well.

• Your Healthcare Needs: Now, there’s much more to making decisions on a health insurance policy than budget comfortability. Whether you’re securing the health insurance policy for yourself or a relative, opting for the most affordable plan might not grant you all the coverage you actually need.

• Your Preferences: If you have preferences for specific doctors and specialists or hospitals close by, it might be wise to consider opting for a private health insurance plan. This is a preferred option for expats, as private health insurance allows access to more multilingual doctors.

Moreover, if your policy features high deductibles, you will pay lower premiums every month or year since you’re responsible for more costs before the coverage begins. You can also use copays to lower premiums by paying a fraction of the medical bills.

For Employers: What to Consider When Offering Group Health Insurance to your Employees

For employers offering group health insurance to your employees, the biggest factor to consider is making sure the benefits align with your employee’s specific healthcare needs. This can be done by holding discussions and surveys to see what each employee needs.

Companies can consider the employees’ age, family members, and medical conditions to come up with the most suitable plan for their employees.

Opting for the cheapest plan might not actually grant employees the coverage they truly need despite the plan being affordable. And for that reason, employers should look beyond budget comfortability when selecting plans for employees.

Conclusion

In conclusion, both types of health insurance have their fair share of benefits and drawbacks. Individual health insurance may be independent but at the cost of being potentially expensive, while group health insurance offers greater coverage but at the cost of being tied to employment.

For both people seeking individual health insurance and employers seeking group health insurance, however, it’s crucial to look beyond budget comfortability in the decision-making process as the most affordable plan might not grant the exact coverage needed.

Being a global health insurance broker and employee benefits specialist, Pacific Prime has 20 years in both health insurance plan selections as well as employee benefits guidance to ensure employees’ voices are heard.

Should you have any questions in health insurance plan selections or employee benefits, please don’t hesitate to get in touch with us and get a free quote here.