Buying Health Insurance for the First Time? Here’s What You Need to Know.

Who Buys Individual and Family Health Insurance?

People who shop for individual and family insurance typically include those who: 

• Don’t have access to employer-sponsored coverage.
• Don’t qualify for government healthcare programs including Medicaid or Medicare.

If you don’t have access to health insurance through an employer or government healthcare programs, purchasing an individual or family plan may be an option for you. 

Ways to Buy Your Own Health Insurance

There are two ways to buy individual and family health insurance, each catering to different preferences and circumstances:

• Health Insurance Marketplace: Individuals and families can purchase health plans through the Marketplace (also known as the Exchange), established by the Affordable Care Act (ACA).
• Direct from insurance companies: Contacting insurance companies online or through their enrollment support team allows you to buy individual and family health insurance plans available on or off the Exchange.

Each enrollment option has its unique advantages, so as you’re deciding how to buy individual health insurance or family health insurance, it’s important to explore the one that best aligns with your needs and preferences.

How to Choose Your First Health Insurance Plan: Tips for Success

When choosing your first health insurance plan, it's essential to compare options and consider several factors to help you make an informed decision.

1. Assess your healthcare needs, taking into account any existing care needs and anticipated medical expenses.
2. Learn about the types of health insurance plans available, such as HMOs, PPOs, and HDHPs. 
3. Understand the meaning of insurance terms related to plan features, including premium, deductible, copays, coinsurance, and out-of-pocket maximum. 
4. Consider additional factors like network coverage, including in-network care providers, hospitals, and specialists. 

Ultimately, choosing a health insurance plan requires careful evaluation of your anticipated care needs and budget to enroll in a plan that best aligns with your health coverage preferences.

When You Can Buy Individual and Family Health Insurance

There are specific windows of opportunity to enroll in an individual and family health insurance plan, on-exchange or off-exchange. Learn more about the enrollment periods so you don’t miss out on an opportunity to buy a health plan. 

Open Enrollment Period

The Open Enrollment Period (OEP) to purchase health coverage occurs annually from November 1 through January 15 in most states. During Open Enrollment, individuals and families can enroll in health insurance or make changes to their existing plan. However, if you miss the Open Enrollment Period, you may still be eligible to purchase or modify your coverage under certain circumstances known as a Special Enrollment Period. 

Special Enrollment Period

If you’re wondering how to buy health insurance outside of Open Enrollment, the answer is during a Special Enrollment Period (SEP). Qualifying life events, such as getting married, having a child, losing existing coverage, or moving to a new area, can make you eligible for an SEP, during which you have a limited time to enroll in a new health insurance plan or make changes to your current one. 

It's important to be aware of these two enrollment periods and eligibility criteria to ensure you know when and how to buy your own health insurance.