Contrary to popular belief, individual and family health insurance coverage is almost always more cost effective than employer health insurance plans. Here’s why:

Employer health insurance (or employer sponsored plans) are offered to full time employees as a benefit for working for the employer. Employer health insurance allows employees to get a health plan with established rates and guaranteed acceptance.

Because employer sponsored plans offer guaranteed acceptance, people with pre-existing health conditions will be accepted. This is a huge benefit of employer health insurance.

The problem is, that in order to pay for the expected claims, the insurance company must increase the rates for the entire group. In my home state, they can increase the starting premium (the ones published in their brochures) 85{0f0fc6bf5bd959fc253a0668ee6b669dcca87a64289522d38fccac0cb86058d7} if one employee (or more than one) has a serious medical condition like diabetes, or even if one person in the group is pregnant. Unfortunately employees who don’t utilize their plan much will pay the same increased rates as the employees with pre-existing conditions who need consistent medical care.

If you or your family don’t have any pre-existing medical conditions, there is an options that allows you to obtain the same or similar coverage at a much better price. This option entails getting your own insurance through a private company that offers individual and family health plans in the private market.

These companies can offer similar or the same coverage at lower prices. They can do this because they only accept applicants with few or no pre-existing conditions. This means there will be less claims, and the insurance company doesn’t have to charge as much in monthly premiums to insure a healthier, pre-screened group of individuals/families. This is a great option if you don’t have serious pre-existing conditions and don’t over-utilize your benefits.

Individual and family health plans are much more cost effective than employer sponsored plans. This is almost always true. But, it’s not true in these two cases.

  • Your employer pays so much of your premium each month that you end up paying less out of pocket for your portion of the insurance premium than you would by paying the total premium through a private health insurance company.
  • You utilize your plan often, have serious pre-existing conditions, or cannot obtain health insurance through private companies.