How Does Group Health Insurance Differ From Individual Insurance

difference between group health insurance and individual

A group plan is a health insurance plan offered by an employer or some type of coalition (like a union or organization for self-employed persons.)

When insurance is purchased by a group – usually through an employer or company – it makes the individual cost for monthly premiums low. In this sense, it can be more cost-effective for individuals to secure group plans – however, they must be part of a qualifying group. Families or groups of friends cannot enroll in group health insurance plans.

Difference Between Group And Individual Coverage

Group plans are offered through private insurance companies and can provide all the same varieties in types of coverage as individual plans. They can provide access to either HMO or PPO networks, they can be short term or long, and the benefits can be fully comprehensive or limited. It just depends on the type of coverage you’re looking for.

What Are The Disadvantages Of Group Insurance?

One disadvantage of group plans, however, is their inability to tailor needs to the individual customer. This means – the coverage is the same across the board for every group member. (Unless the employer offers supplemental add ons), this means everyone pays the same premiums for themselves, and for each family member added and recipes the same care for each person at a fixed price.

In this sense, if a family member or an individual requires special care for a medical condition – they may need additional coverage outside of the benefits offered by their group plan (leaving them paying more out of pocket.)

Can I Get Group Health Insurance?

To secure a group plan, you must deal directly with a group plan specialist. This way, the health care professional can present the various types of plans offered to the employer or organization leader to select the plan that makes the most sense for the employees or coalition members.

While group plans offers affordable rates to an individual , the coverage can be limited. If you are in a position where you might be choosing between individual coverage or a group plan, as well as a situation where you might be considering offering employees group coverage or individual coverage, be sure to consult a professional. Never hesitate to simply #ask the Art of Insurance.