What are the Differences Between Individual and Group Health Plans?

There are several key differences between the ways individual and group health plans function. The basic explanation would go something like: Group health insurance policies include two or more individuals and an employer/sponsor who pays at least 50% of the plan premium. Individual Health Insurance Plans cover only one family or individual.

Who Are Individual Health Plans For?

Individual health plans are designed to offer health insurance coverage too you if you’re either unemployed, self-employed or aren’t eligible for an employer-sponsored plan. Reasonably priced individual health plans can often be difficult, though not impossible to find.

Those of us with a pre-existing or previously diagnosed health problem seeking a new health insurance policy are often considered too high-risk by health insurance carriers—and may not be able to find an affordable health insurance plan or any health plan at all for that matter.

How Do Group Health Plans Differ?

By way of contrast, a group health plan, that provides coverage for two or more people, aren’t typically allowed to deny high-risk individuals health coverage. Everyone eligible for the plan is guaranteed coverage regardless of existing medical issues, and the higher-risks have been factored into the cost of a group plan.